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.

Because in traditional Hindu culture menstruation is associated with a variety of social taboos, prolonged menstrual bleeding produced conflicts within families. The whole idea of fertility regulation was still extremely new in this setting and many husbands and other family members were angry when they found out that women had decided on their own to use the method and had gone to the clinic in secret.

I would like to see policy makers and international donor agencies realize that it is not enough to give money for demonstration projects. From the very beginning plans should be made for the scaling-up of successful innovations.

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.

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 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.

International "experts" from technical assistance agencies or universities can make important contributions, but they certainly don't have all the answers. When ownership is local and national, and various stakeholders work together, program innovations have a greater chance to take root and survive.