The positive deviance approach identifies and promotes existing
uncommon healthy behaviours. A positive deviance-informed antenatal
project was pilot-tested in Al-Minia Governorate, Upper Egypt, during
2003-2004, after a positive deviance study in 2000 found that
successful pregnancies had in\uadcreased consumption of meat and
vegetables, daytime rest, and antenatal care; less second-hand smoke
exposure; and symptoms of no urinary tract infection. Accordingly,
health facilities were upgraded in target and comparison areas to
provide quality antenatal care, including treatment of urinary tract
in\uadfection. Additionally, in the target villages, women at-risk of
delivering low-birth-weight infants were enrolled in weekly 'IMPRESS'
(improved pregnancy through education and supplementation)
ses\uadsions with counselling and supplemental food. In total, 519
women (344 target, 175 comparison) were enrolled in the third or fourth
month of pregnancy and were followed through delivery. Birth-weights of
the target mothers increased 2.2 times more than birth-weights of the
comparison mothers over baseline (mean increase: 0.58 vs 0.26 g
respectively, p<0.01). Similarly, the decrease in prevalence of low
birth-weight from baseline was greater in the target villages than in
the comparison mothers (% of decrease: 26.9 vs 11.9 respectively,
p<0.01). The target at-risk women were far more likely than their
counterparts to report eating more food (54.9% vs 10.6%), more meat
(57.1% vs 4.2%), more vegeta\uadbles (66.9% vs 5.3%), increasing
daytime rest (64.1% vs 11.7%), and avoiding second-hand smoke (91.3% vs
51.6%) during pregnancy. The cost per 100 g of improvement in
birth-weight was US$ 3.98. The Government of Egypt and partners are
scaling up the elements of the project