Case report: Heterotopic pregnancy - A very unlikely cause of haemoperitoneum in trauma setting.

Heterotopic pregnancy is a rare occurrence whereby a concurrent intrauterine and extrauterine pregnancy exists. It is a difficult diagnosis to make early, and often associated with significant morbidity and mortality from complications if diagnosed late. In this report, we present a rare case of heterotopic pregnancy in a 25-year-old woman who presented with abdominal pain following blunt abdominal trauma, and ultrasound showing haemoperitoneum and a viable intrauterine 10-week gestation.

Community engagement, personal responsibility and self help in Cuba's health system reform.

In 2011 the Cuban health system began a process of sectoral reform to maintain and improve the health of Cuba's population, in response to new challenges and demands in the health sector and population health status. The main actions involved are reorganization, consolidation and regionalization of services and resources. Although community engagement and personal responsibility are not explicitly mentioned in the strategy document, it is advisable to use this opportunity to revitalize both topics and encourage appropriate and full incorporation into the Cuban health system.