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.

A longer time perspective is needed because we face a daunting task both in an intellectual and practical sense.

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.

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

If policy makers and program managers participate in an interdisciplinary assessment team, make informal visits to local families and have in-depth conversations with local providers and health authorities, the real needs and complex challenges of organizing good reproductive health services become apparent.

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

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