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.

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

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

Nobody had counseled women to expect the changes in bleeding patterns which are typically associated with IUD use, and they received no support from the health clinics with their problems. Because in traditional Hindu culture menstruation is associated with a variety of social taboos, prolonged menstrual bleeding produced conflicts within families.

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.

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.

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.