The future health and productivity of a nation requires that increasing proportions of the population are reasonably well-educated, healthy, and economically productive. Currently, many Latin American and Caribbean youth do not complete sufficient education to equip them for productive labor in a modern society. Teen sexuality, pregnancy, and childbearing present major health issues, with the health risks to young women from illegal abortions posing a significant problem. The consequences of gang and domestic violence are severe in many countries of the region. Programs that focus only on addressing single problems, however serious, do not change the lives of youth, since they treat only the symptoms rather than the underlying problems. Effective programs must begin early in children's lives, work with youth for years, and holistically and comprehensively address the needs and aspirations of youth, including those of their families, peers, and neighborhoods. Programs must promote positive behaviors, offer activities and opportunities that give youth reasons to expect a decent future, and promote the capacity for participation and self-determination. The opportunity to develop stable relationships with competent and caring adults is an especially critical component of successful programs. Steps in establishing strong comprehensive programs involve establishing priorities and securing commitment; identifying target populations and involving youth in planning; deciding which services and activities to offer, where they will be located, and how they will be coordinated; handling administrative, staffing, and funding issues; and maintaining program integrity. This paper also provides guidance on securing technical assistance and conducting program evaluations. 1 table and 65 references