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.

We are trying to discover where this approach could have the greatest possibility of large-scale impact. We have to choose wisely and see where there is greatest interest and need.

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.

One of the things we have learned in the first year is that if you want to scale-up, the first thing you have to do is to expand your own team.

It really pains me greatly to hear from graduate students that graduate education is a lower priority here.

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."

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.