the most important thing one can do for children is not accept the limitations they are so willing to impose on themselves.

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.

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

When we conducted focus group interviews in the first municipality in Brazil before initiating the pilot project, a woman commented: Getting an appointment in the public sector municipal health services is like "winning the lottery." 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.

In fact it is essential that we strengthen efforts to learn from each other, and stop considering public health in the third world and in the U.S. as separate intellectual and practical endeavors.

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.