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.

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.

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.

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.

A focus on people's health and well-being must be the core of family planning research and policy. This may seem self-evident, but the realities of program implementation in third world countries has often shown that the health and well-being of individuals is not a priority.

Bureaucratic systems are not set up to be what we refer to as human service organizations. They were established to collect revenue and maintain law and order and they used a law and order approach in providing family planning services.

We wanted to see how access to care can be expanded and service quality can be improved when one uses a participatory approach to program development. We showed that 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. In time leaders from other municipalities expressed interest in replication and the project succeeded in expanding innovations to three other areas.