Part 4 of 14 in How Social Impact Startups Build on Success: A Positive Deviance Guide for Indian Founders← Part 3Part 5 →
This chapter presents Indian examples of Positive Deviance in nutrition, maternal health, and adolescent anaemia. It helps health and nutrition startups identify practical behaviours already working among families, schools, villages, and health systems with similar resources.
- Vadodara families supported child nutrition through colostrum, frequent breastfeeding, timely thicker complementary foods, and active feeding.
- Rural Bangalore reduced underweight prevalence by working through Anganwadi centres and successful mothers from the same communities.
- Madhya Pradesh families improved nutrition through supportive fathers, financial planning, shared meals, nutrition knowledge, and joint decisions.
- In Palwal, positive deviant pregnant women sought care early, ate better, stayed active, and used safe sleep positions.
- Khunti showed that girls, schools, and villages could improve anaemia control using iron-rich foods, tablets, and hygiene practices.
India has applied Positive Deviance extensively in nutrition. The evidence is strong, local, and directly useful for health and nutrition startups.
Vadodara Urban Slums
Researchers studied 6–18 month old children in Vadodara slums. Positive deviant children (normal weight-for-age) came from smaller families, had lower parity, longer birth intervals, received colostrum (96 percent versus 26 percent in the comparison group), were breastfed more frequently (at least 8–9 times a day), started complementary feeding at the right time with thicker consistency, and were actively fed. Their calorie intake from complementary food was significantly higher. Diarrhoea episodes were fewer. These practices were accessible to other families living in the same slums with the same resources.
The study showed that the factors contributing to positive deviance in urban poor families were similar to those reported in rural India. The implication for startups and for ICDS is clear: national infant and young child feeding guidelines are already being followed by some families. The work is to help more families practise them, not to invent new guidelines.
Rural Bangalore and the ICDS System
In rural Bangalore Anganwadi centres, an interventional study used nutrition education based on the Positive Deviance approach combined with supplementary nutrition. Underweight prevalence among 2–6 year old children fell from 47 percent to 30 percent over one year. Successful mothers from the same centres were identified and used as change agents. The method strengthened the existing ICDS system rather than replacing it.
This is an important lesson for startups. Working with and through Anganwadi workers and successful mothers inside the system is more sustainable than building a parallel nutrition programme. The positive deviant mothers already exist inside the Anganwadi catchment areas.
Madhya Pradesh: Gender, Fathers and Nutrition
A GIZ-supported Positive Deviance inquiry in rural Madhya Pradesh found that families with better-nourished mothers and children practised uncommon gender-related behaviours. Supportive fathers undertook conscious financial planning to ensure good nutrition for mother and child. They attained knowledge about nutrition. They avoided alcohol. They fed the child in the morning before work. Families ate together (the mother was not eating last). Joint decision-making occurred on family planning.
Many of these practices were validated by the community in focus group discussions as adoptable. Practices related to alcohol consumption and family planning required broader action, but the majority of the discovered practices were doable at the household level. The study showed that Positive Deviance can surface gender dynamics that conventional nutrition programmes often miss.
Palwal, Haryana: High-Risk Pregnancies
Among high-risk pregnant women in Palwal district (an area with persistently high stillbirth rates), positive deviant women who delivered healthy live births without adverse neonatal events showed proactive health-seeking behaviour, better nutrition (milk, fruits such as pomegranate and apples, soaked dry fruits, green leafy vegetables), culturally rooted physical activity, and safe sleep positions. These behaviours were often supported by Accredited Social Health Activists (ASHAs), husbands and other family members.
In contrast, women who experienced stillbirth or early neonatal death faced delays in care-seeking, adverse traditional practices, partial information, and barriers in healthcare seeking. The positive deviant practices were culturally acceptable and did not require additional resources beyond what was available to other high-risk pregnant women in the same area.
Jharkhand: Adolescent Anaemia in Tribal Communities
In tribal areas of Khunti district, a government-led Positive Deviance process addressed low compliance with the adolescent anaemia control programme. Prevalence of anaemia among adolescent girls was around 70 percent. The process identified positive deviant adolescent girls who regularly consumed a variety of iron-rich foods, took iron-folic acid tablets, and practised recommended personal hygiene behaviours despite the same constraints as their peers. Positive deviant schools and villages supervised tablet distribution more effectively.
The government-led nature of the process was significant. It gave government functionaries a structured way to listen to communities, dialogue with them, and adapt the programme according to local needs. The positive deviants existed among the girls, the schools and the villages. The solution was already inside the system.
These Indian nutrition and maternal health stories share a pattern. The practices were already present, culturally acceptable, and required no extra resources. The intervention created the social process for others to adopt them. Startups working on maternal and child health, nutrition, or adolescent health can use the same logic inside their focus geographies.
Frequently asked questions
What did positive deviant families in Vadodara do differently?
They gave colostrum, breastfed at least 8 to 9 times daily, started thicker complementary foods at the right time, actively fed children, and provided more complementary-food calories.
How did Positive Deviance reduce underweight prevalence in rural Bangalore?
Nutrition education was combined with supplementary nutrition through Anganwadi centres. Successful mothers from the same centres acted as change agents, and underweight prevalence fell from 47 percent to 30 percent in one year.
What role did fathers play in nutrition in Madhya Pradesh?
Supportive fathers planned finances for nutrition, learned about nutrition, avoided alcohol, fed children before work, and supported families eating together.
How did Khunti address adolescent anaemia?
The process identified girls who ate varied iron-rich foods, took iron-folic acid tablets, and followed hygiene practices. Positive deviant schools and villages supervised tablet distribution more effectively.