This article outlines the process through which India has shifted its priorities from a narrow family planning focus to a broader reproductive health orientation in which quality and informed choice are prominent features, and we have identified the tasks that lie ahead in making this shift a reality. Altering the perspective of stakeholders to more fully accept the new approach, though, remains an overarching challenge that cannot be underestimated. It is somewhat naive to expect that well-entrenched practices and messages established over 25 years will change on their own, without resistance, simply because of a centrally sponsored policy change. Indeed, service providers, program implementers and policymakers at all levels need to grasp, and be convinced of, the rationale underlying the shift in priorities and delivery strategies. Clients, equally, need to grasp that health services are their due and to demand accountability from the health system. It is critical that changes in priorities and programs be translated and communicated effectively and convincingly.