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.

If we succeed in learning more about how to expand program innovations from pilot projects so that they have broader program impact, this should be very relevant for public health initiatives in Michigan and elsewhere in the US.

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.

We felt that the Gates Foundation looked at our track record and our publications and decided that "this is persuasive; this needs to be done. Let's see what they can do."

High level policy makers and program managers do not normally listen to the voices of local people, local providers and local program managers when they make decisions about contraceptive introduction or other aspects of program development in reproductive health.

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.

I came to understand the value of education, not just to enable me to make a good living, but to enable me to make a worthwhile life.