Positive Deviance pada Status Gizi Balita

Background: Positive Deviance (PD) is a ‘power' based approach having a belief that in each community there are certain individuals as the actors of ‘positive deviance' that own specific habit and behavior. They might find out better ways to prevent nutritional deficiency compared to their surroundings that possess the same resource and face the same risk as well.Objective: To find out PD behavior in poor family towards under-five children's nutritional status in Astanajapura Health Center working area of Cirebon District.Method: The study used a case control study design and in-depth interview. Subjects were under-five children 6-59 months of age. Data collection used a questioner and interview. Data analysis used univariate, bivariate, and multivariate analysis with logistic regression to determine OR and 95% CI of the effect of PD behavior towards under-five good nutritional status.Result: Under-five good nutritional status was significantly related to PDbehavior (OR=7.43; 95% CI=1.89–29.17). The other factors affecting under-five good nutritional status were maternal education (OR=6.63; 95%CI=1.63–23.90) and under-five age (OR=4.05; 95% CI=1.16–14.10).Conclusion: Under-five good nutritional status had a significant relationship with PD behavior

Analisis Upaya Pemberdayaan Masyarakat oleh Bidan Desa melalui Pendekatan Positive Deviance pada Perbaikan Gizi Balita di Kabupaten Bojonegoro Tahun 2013

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2015 ABSTRAK Maya Primayanti Analisis Upaya Pemberdayaan Masyarakat oleh Bidan Desa melalui Pendekatan Positive Deviance pada Perbaikan Gizi Balita di Kabupaten Bojonegoro Tahun 2013 xvii + 257 halaman + 9 tabel + 4 gambar + 16 lampiran Pada akhir tahun 2012, 56,27% desa di Kabupaten Bojonegoro melakukan pemberdayaan melalui positive deviance (PD). Namun, penurunan presentase balita gizi kurang dan gizi buruk tidak dapat dipertahankan. Tujuan penelitian menganalisis upaya pemberdayaan masyarakat oleh bidan desa melalui pendekatan positive deviance pada perbaikan gizi balita di Kabupaten Bojonegoro. Penelitian dilakukan secara kualitatif. Informan utama 8 bidan desa (4 bidan desa PD kriteria baik dan 4 bidan desa PD kriteria kurang baik) dan informan triangulasi 28 orang (8 kader PD, 8 perangkat desa, 8 ibu balita dan 4 petugas gizi). Data dikumpulkan dengan teknik wawancara mendalam. Pengolahan dan analisis data menggunakan analisis isi. Hasil penelitian menunjukkan upaya pemberdayaan masyarakat oleh bidan desa PD kriteria kurang baik belum optimal dibandingkan PD kriteria baik. Hal ini berkaitan dengan : 1) bidan belum mengupayakan kader meningkatkan partisipasi ibu balita sampai membawa kontribusi bahan makanan dan membantu memasak, 2) pemimpin desa kurang memotivasi dan menggerakkan partisipasi masyarakat, 3) bidan belum memanfaatkan organisasi masyarakat desa sepenuhnya untuk meningkatkan partisipasi masyarakat, 4) bidan belum mengupayakan kader melakukan penyelidikan PD untuk mencari role model sebagai dasar pembuatan menu dan pemberian pesan kesehatan, 5) mobilisasi sumberdaya kurang dalam hal dana swadaya masyarakat atau ADD, serta keaktifan semua kader, 6) kemitraan bidan dengan perangkat desa dan kader belum didukung SK PD dan kesepakatan yang saling menguntungkan, 7) bidan belum mengupayakan kader melakukan evaluasi PD sampai kunjungan rumah, serta tidak ada supervisi rutin dan penilaian/umpan balik pelaksanaan PD dari petugas gizi. Disimpulkan bahwa pelaksanaan PD belum berkelanjutan sesuai harapan. Diperlukan kerjasama semua pihak dalam mewujudkan program tersebut. Disarankan kepada Dinas Kesehatan untuk melakukan pelatihan PD bagi bidan dan kader, serta penempatan tenaga gizi sesuai kompetensi. Disarankan kepada puskesmas untuk meningkatkan komitmen perangkat desa dan pemberian insentif kader. Kata Kunci : Pemberdayaan Masyarakat, Positive Deviance, Perbaikan Gizi Balita Pustaka : 63 (1983-2013) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Maternal and Child Health 2015 ABSTRACT Maya Primayanti Effort Analysis of Community Empowerment by Village Midwife through Positive Deviance Approach in Improving Nutrition of Children under Five years old in Bojonegoro District in 2013 xvii + 257 pages + 9 tables + 4 figures + 16 enclosures In the end of 2012, 56.27% of villages in Bojonegoro District had empowered community using positive deviance (PD) approach. However, a decreasing percentage of severely and moderately malnourished children under five years old could not be maintained. The aim of this study was to analyse efforts of community empowerment by village midwife through PD approach in improving nutrition of children under five years old in Bojonegoro District. This was qualitative research. Main informants consisted of eight village midwives (4 midwives with good PD and 4 midwives with bad PD). Meanwhile, 28 persons (8 cadres of PD, 8 village officials, 8 mothers of children under five years old, and 4 nutritionists) were as informants for triangulation purpose. Data were collected using indepth interview method. Furthermore, data were analysed using content analysis. The results of this study showed that efforts of community empowerment conducted by village midwives with bad PD had not been optimal compared to those with good PD. Some reasons for this problem were as follows: 1) midwives had not empowered cadres to increase participation of mothers of children under five years old in order to bring groceries and help cooking; 2) head of villages had not motivated and actuated participation of communities; 3) midwives had not fully utilised villagers’ organisation to increase participation of community; 4) midwives had not empowered cadres to investigate PD for finding role model as a basis of making menu and providing health messages; 5) there was lack of resources mobilisation particularly in terms of self-funding or ADD and activeness of all cadres; 6) partnerships between midwives, village officials, and cadres had not been supported by decree of PD and mutual agreements; and 7) midwives had not empowered cadres in evaluating PD and visiting a house. In addition, there were no regular supervisions and feedback of PD implementation from nutritionists. In conclusion, the implementation of PD had not complied expectation. Therefore, cooperation with other sectors needs to be done to realise its program. District Health Office needs to conduct training of PD for midwives and cadres and place nutritionists in accordance with their competencies. Health centres need to improve commitment of village officials and provide incentive for cadres. Key Words : Community Empowerment, Positive Deviance, Improvement of Nutrition of Children under Five Years Bibliography : 63 (1983-2013

Daerah Positive Deviance sebagai Rekomendasi Model Perbaikan Gizi

This research aimed to improve nutritional status of toddler by applying positive deviance areas model and to establish a pilot model  of positive deviance areas mapping between positive deviance good nutritional  statuses of toddler and the vulnerable nutritional status of toddler in Boyolali District. This study used quantitative and qualitative approaches, with purposive sampling and snow ball sampling technique. Conclusions of this study were (1) map of positive deviance regionbetween nutritional status and environmental Boyolali district, which was in 2 areas namely Karanggede and Juwangi health center, (2) the short-term recommended model were improving nutritional status by empowering the people who possess the potential, especially in social and culture, which include aspects of social organization, knowledge and language, occupation, as well as technology and equipment

Explaining positive deviance in public sector reforms in development

Public sector reforms are commonplace in developing countries. Much of the literature about these reforms reflects on their failures. This paper asks about the successes and investigates which of two competing theories best explain why some reforms exhibit such positive deviance. These theories are called 'solution- and leader-driven change' and 'problem-driven iterative adaptation'. They are used to analyse data emerging from a case survey involving thirty cases from Princeton University's Innovations for Successful Society programme. The bulk of evidence from this study supports a problem-driven iterative adaptation explanation, but there is reason to believe that solution- and leader-driven change hypotheses also have value. It seems that problem-driven iterative adaptation and solution- and leader-driven change are two viable paths through which positive deviance can emerge; although problem-driven iterative adaptation seems to provide the wider path for more positive deviance

Correspondence regarding 'Assefa Y, et al., BMC Health Services Research. 2011; 11 (1):81 and 2014; 14(1):45': The Positive-Deviance approach for translating evidence into practice to improve patient retention in HIV care.

The purpose of this correspondence is to describe how the positive-deviance approach can be used to translate evidence into practice, based on successive studies conducted in Ethiopia. In earlier studies, it was identified that retention in antiretroviral treatment care was variable across health facilities; and, seeking compliance across facilities, a framework was developed based on the practices of those positive-deviant health facilities, where performance was noted to be markedly better. It was found that the positive deviance approach was effective in facilitating the transfer of innovative practices (using different mechanisms) from positive-deviant health facilities to negative-deviant health facilities. As a result, the variability in retention in care across health facilities narrowed over time, increasing from 83 to 96% in 2007/8 to 95-97% in 2013/14. In conclusion, the positive-deviance approach is a valuable tool to translate evidence into practice, spread good practices, and help achieving universal health coverage

Deviant Citizenship Behavior: A Comprehensive Framework towards Behavioral Excellence in Organizations

Purpose – While studying the topic of seeking behavioral excellence (proactive and creative competence) in organization, scholars have presented a variety of literature sprinkled with countless theories on behavioral competence. Research design, data, and methodology - Foremost among the several theories on this topic are two distinct sets of behav-ioral theories: OCB (Organizational Citizenship Behavior) and Constructive Deviance. Both of these theories attempt to posit their usefulness in positive organizational outcomes (such as organizational effectiveness, quality, performance, and innovations). Results - However, their proposed constructs are opposing and studies are conducted in isolation, thereby creating a sigificant literature gap and omitting the possibility of being inclusive of the best that both OCB and constructive deviance have to offer. Conclusions - The article bridges the gap by critically examining OCB and constructive deviance and including a consideration of other empirical studies in an attempt to be comprehensive while, at the same time, seeking to find an effective behavioral construct that is both appropriate and conducive for positive organizational outcomes in the context of the current business environment

Positive deviance: a different approach to achieving patient safety

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