My colleagues from the Department of Health Behavior and Health Education are working on participatory public health initiatives in Michigan, and there is much that we can learn from each other. In fact it is essential that we strengthen efforts to learn from each other, and stop considering public health in the third world and in the U.S. as separate intellectual and practical endeavors.

Nobody had counseled women to expect the changes in bleeding patterns which are typically associated with IUD use, and they received no support from the health clinics with their problems. Because in traditional Hindu culture menstruation is associated with a variety of social taboos, prolonged menstrual bleeding produced conflicts within families.

When we conducted focus group interviews in the first municipality in Brazil before initiating the pilot project, a woman commented: Getting an appointment in the public sector municipal health services is like "winning the lottery." I would like to make it possible for many women and men in Latin America to win the lottery and receive the type of reproductive health services they so urgently need.

Strategies for research and policy development must simultaneously address people's needs, the capacity of programs to provide good quality of care, and the range of technological options available.

In fact it is essential that we strengthen efforts to learn from each other, and stop considering public health in the third world and in the U.S. as separate intellectual and practical endeavors.

If policy makers and program managers participate in an interdisciplinary assessment team, make informal visits to local families and have in-depth conversations with local providers and health authorities, the real needs and complex challenges of organizing good reproductive health services become apparent.

I was intent on doing something productive and on being everything my parents taught me to be. Their values were clear: do good work; don't ever get too big for your breeches; always be an authentic person; don't worry too much about being famous and rich because that doesn't amount to too much.