Major changes become possible if you work in a participatory manner, listen to local people, diagnose what the problems are, provide training and identify where there are opportunities for mobilizing local resources to take action.

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.

Governments have a legitimate concern with slowing population growth. But often this has been attempted with little concern for the individuals most affected.

I'm the youngest of 12 children. And although I was the youngest, I tried to organize things in my family. When there were disputes, I tried to mediate.

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 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.

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."