Suchergebnisse

The Program of All-Inclusive Care for the Elderly (PACE) is an innovative model of comprehensive long-term medical and social services. The system receives monthly capitation payments from Medicare and Medicaid for clients who are nursing-home eligible. PACE was developed originally by On Lok Senior Health Services in San Francisco's Chinatown in the late 1970s. PACE is based upon the concept of maintaining the independence, autonomy and dignity of frail and disabled elders nearing the end of life (Sapir, 1996). The program's underlying principle is to keep participants (PACE program enrollees) in the community for as long as it remains medically, socially, and economically feasible (Shen and Iverson, 1992). There is also a strong intention to preserve and support the older adult's family unit.

Two decades ago, the genocide against the Tutsis in Rwanda led to the deaths of 1 million people, and the displacement of millions more. Injury and trauma were followed by the effects of a devastated health system and economy. In the years that followed, a new course set by a new government set into motion equity-oriented national policies focusing on social cohesion and people-centred development. Premature mortality rates have fallen precipitously in recent years, and life expectancy has doubled since the mid-1990s. Here we reflect on the lessons learned in rebuilding Rwanda's health sector during the past two decades, as the country now prepares itself to take on new challenges in health-care delivery.