When implementation of CARE's large and innovative child survival project in Bolivia fell behind schedule in July 1986, a team from the Water and Sanitation for Health (WASH) project was called in to conduct a project review workshop. Interviews prior to the workshop revealed great confusion among project participants regarding project goals, strategy, and operational roles. The workshop helped all the participants reach a common understanding about these matters. Working agreements on expectations for performance were made among and between USAID/B, the CARE central and regional offices, the Ministry of Health (MOH), and the Local Development Corporations. A written set of responsibilities was developed for each entity, a national-level advisory committee was set up to guide and coordinate activities, and regional implementation and coordination committees were set up at each CARE regional office. A framework for dealing with field-level implementation issues was established and a start was made in dealing with technical issues in water, latrines, community organization, the project's information base, and its integrated health strategy. Recommendations in this workshop report address design issues, the project's implementation strategy, workshop follow-up, and the importance of conducting such workshops prior to start-up of complex projects.