“…The weaknesses of the IMSS committees are not substantially different from those reported from committees in other countries which report difficulties in terms of their composition [5,8,9], mode of operation [5][6][7][8][9][10]58,59], and potential conflicts of interest [26,53,57,60]. Claims for standardised procedures [7][8][9]60,61], training [5,10,57,60], and the implementation of audit practices [7,10,38,57,58,61] to improve the LRECs workings are found in literature worldwide.…”