The Pan American Network of Nursing and Midwifery Collaborating Centers (PANMCC) met at the Pan American Health Organization in Washington, D.C. 7-8 October, 1998 to discuss possibilities for supporting the new Strategic and Programmatic Orientations (SPOs) 1999-2002 approved by the Pan American Sanitary Conference in September, 1998. Thirty-five participants from 13 of the 14 existing Centers from throughout the Region were represented. The meeting was made possible through special funds provided by the Director of PAHO for one meeting of Collaborating Centers per Division in 1998 to promote networking around specific areas of work. The participants discussed the strengths of their Centers and how these technical resources could be utilized by PAHO in implementing the new program of work starting in 1999. Following an initial overview by the Director of the Division of Health Systems and Services Development, work sessions were held on a variety of topics in the area of health systems development where issues important for nursing and midwifery in human resources development and the organization of health systems and services are being considered. These areas included public health, vulnerable populations, technical level education programs, cost-effectiveness of advanced nursing practice models, management, information systems, and research on impact of health sector reform. During afternoon sessions, groups met with other PAHO programs (reproductive health, mental health, AIDS, palliative care, and ethics) to discuss options for future work in those areas. Summaries of these discussions reflect the interest of PAHO Programs to involve the Centers. They also make note of the technical resources of the Centers which could support PAHO’s work. During the business meeting of PANMCC, progress in implementing the strategic plan was discussed and new activities were added to the plan of work. One activity planned for 1998 is a pilot of a report, which asks each Center to summarize specific substantive work, relating to the PAHO Strategic and Programmatic Orientations. A highlight of the two-day meeting was the presentation of the results of a multi-site research project on the impact of health sector reform on nursing practice and education carried out in five countries –Argentina, Brazil, Colombia, Mexico, and USA. (AU)