It was June 2005. Eight women arrived at the meeting hall in Antananarivo, Madagascar, dressed in their Sunday best. The Ministry of Health & Family Planning had asked these community volunteers to participate in a full-day family planning workshop.

Over the course of the day, these eight women, all of them trained through a program funded by the US Agency for International Development (USAID), listened to dignitaries and met the event organizers, watched a video, and participated in...

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