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.

We hope to organize team residencies and a conference bringing together professionals from Latin America and from other groups around the world who are also focusing on this issue. We want to bring them together so we can learn from each other, and then widely publicize our conclusions.

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.

Probably the first time I was a boss was when I was associate dean of the graduate school at the University of Southern California. I was in my early 30s.

Bureaucratic systems are not set up to be what we refer to as human service organizations. They were established to collect revenue and maintain law and order and they used a law and order approach in providing family planning services.

It all started in India in the late 60s when I began helping my husband George, who was in the population field, evaluate the introduction of the intrauterine contraceptive device. At that time the IUD was considered to be the panacea for India's population problem. George's dissertation was focused on population and he became interested in the question of this new technology and how people were responding to it.

Our practical purpose is to facilitate expansion of service innovations on a larger scale to improve access to, and the quality of reproductive health care. We are very grateful to have received support from the Bill and Melinda Gates Foundation to continue our work.