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.

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.

There's nothing worse than a leader who lacks ambition.

Fear of failure is the fuel of achievement. If you weren't afraid to fail, you probably wouldn't be highly motivated to work at the level that most of us have to work at to do well.

If you want to scale-up, the first thing you have to do is to expand your own team.

In the late 60s, 70s and possibly early 80s, social scientists were interested in researching the diffusion of innovation and studying the link between applied research and policy and program development. Recently there has been less interest in these issues and we feel that this interest must be rekindled.

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.