TAILIEUCHUNG - Health sector reform and reproductive health in Latin America and the Caribbean: strengthening the links

The total number of mammalian cortical granule proteins has been estimated to be between four and fourteen or more [10,19,20]. Several specific proteins have been iden- tified as cortical granule proteins [21]. N-acetylglucosami- nidase was detected in exudates of ionophore-activated mouse oocytes using an enzymatic assay and was local- ized in the cortical granules at the electron microscopic level [13]. Approximately 90% of oocyte N-acetylglu- cosaminidase was released following in vivo fertilization and was shown using competitive inhibitors or anti-N- acetylglucosaminidase antibodies to be responsible for the zona block to polyspermy [13]. Ovoperoxidase was detected in the cortical granules of unfertilized mouse oocytes at the ultrastructural level using the '-diami- nobenzidine (DAB). | Health sector reform and reproductive health in Latin America and the Caribbean strengthening the links A. Langer 1 G. Nigenda 2 J. Catino3 Many countries in Latin America and the Caribbean LAC are currently reforming their national health sectors and also implementing a comprehensive approach to reproductive health care. Three regional workshops to explore how health sector reform could improve reproductive health services have revealed the inherently complex competing and political nature of health sector reform and reproductive health. The objectives of reproductive health care can run parallel to those of health sector reform in that both are concerned with promoting equitable access to high quality care by means of integrated approaches to primary health care and try the involvement ofthe public in setting health sector priorities. However there is a serious risk that health reforms will be driven mainly by financial and or political considerations and not by the need to improve the quality of health services as a basic human right. With only limited changes to the health systems in many Latin American and Caribbean countries and a handful of examples of positive progress resulting from reforms the gap between rhetoric and practice remains wide. Keywords reproductive medicine health sector reform health services accessibility financing health Latin America Caribbean region. Voirpage 674 le résumé en franpais. En la página 675 figura un resumen en espano Introduction The health sectors in many countries of Latin America and the Caribbean LAC in different ways at different speeds and with mixed results are currently being transformed 1 by the introduction of sectorwide reforms to make the health services more effective and efficient . improving service quality and access decentralizing management and decision-making controlling costs and expanding the role of the private sector and 2 by the adoption of a broad-based reproductive health care model in accord .

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