There is strong mentoring of women in the academy. Corporations appear more willing to resist affirmative action to advance women, and boards and shareholders are more tolerant of this approach.

We have emphasized the importance of applied action research because it allows evidence-based policy and program development and a focus on learning. We are also committed to using a participatory approach in which local people, local program managers and providers, local researchers, women's health activists, and national decision-makers play the leading role. International "experts" from technical assistance agencies or universities can make important contributions, but they certainly don't have all the answers.

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.

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.

If you are the kind of person who listens to conservative advice, you may do okay in life, but you probably won't ever be a fantastic leader. You have to take risks, and you also have to go against conventional wisdom, because conventional wisdom doesn't make for startling advances in society.

When ownership is local and national, and various stakeholders work together, program innovations have a greater chance to take root and survive.

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.