CZECHOSLOVAKIA, the Czechoslovak Socialist Republic, ChSSR — the state in Central Europe. The area is 127,9 thousand sq.km. The population apprx. 15,5 million people (January, 1985). The capital — Prague (apprx. 1,2 million zhit., January, 1984). Ofits. languages — Czech and Slovak.
Till 1918 Czechoslovakia was a part of Austria-Hungary. The great October socialist revolution which led to weakening of world capitalist system caused powerful rise of revolutionary movement in Austria-Hungary and created premises for a successful completion of national liberation fight of the Czech and Slovak people. Also defeat of Austria-Hungary in World War I played a role. In the fall
of 1918 the independent Czechoslovak state was created. Founded in 1921. The Communist Party of Czechoslovakia led consecutive fight in protection of interests of workers, for the democratic solution of an ethnic question, for the union and friendship with the USSR.
Increase of threat from Hitlerite Germany and the requirement of a people at large forced the government of the country to sign the contract with the USSR on mutual aid in 1935. However the bourgeois government of Czechoslovakia which was guided by the western countries rejected the military aid offered the USSR. As a result of the Munich agreement of the western powers and capitulation of the bourgeois government Ch. in September, 1938
nearly 1/4 territories of the country was taken by Hitlerite Germany. In March, 1939 Germany completely occupied the Czech lands, having created so-called protectorate of the Czech Republic and Moravia and the puppet Slovak fascist state.
In the spring of 1945 after Ch.'s release from fascist aggressors by the Soviet Army with participation of Czechoslovak soldiers the government of the National Front came to the power, a cut started democratic transformations and as fundamentals of the foreign policy defined orientation to the union with the USSR. In February, 1948 workers under the direction of the Communist Party inflicted decisive defeat over the reactionary bourgeoisie trying to make a counter-revolutionary coup and to recover capitalist orders in the country. The country took constructions of socialism a way. By 1960 socialist relations of production in Ch. became prevailing. Exploiter classes were liquidated, industrial potential increased, welfare of workers increased, great success is achieved in development of education, sciences, cultures, generally socialist transformations in the village are complete; economic backwardness of Slovakia is overcome. The win of socialism was sealed in the new constitution of ChSSR (1960).
Since 1969 ChSSR — federation of two equal republics — the Czech Socialist Republic (CSR) and the Slovak Socialist Republic (SSR). The supreme body of the government and the Supreme legislature of ChSSR — the Federal Assembly consisting of National chamber and Chamber of nationalities. The Federal Assembly at a joint meeting of both chambers elects the president. The supreme executive body — the Federal government.
The leading and directing force of Czechoslovak society — the Communist Party of Czechoslovakia (CPC). Wide people at large of the country is united in the National Front of ChSSR expressing unity of the main class, national and international interests of workers. The National Front, except KPCh, includes the Revolutionary trade-union movement, the Socialist union molode-
zhi and other public organizations of workers, and also Czechoslovak People's Party, the Czechoslovak Socialist Party, Party of the Slovak revival and the Slovak Party for Freedom supporting the program of construction of socialism and recognizing the leading role of KPCh.
ChSSR — the participant of the Warsaw Pact and the member of SEV (see Council of economic mutual assistance). In the foreign policy Ch. proceeds from a course towards strengthening of unity of the socialist commonwealth, every possible development of cooperation with the brotherly socialist countries, strong friendship and the union with the USSR. In March, 1980 the Long-term program of development of specialization and cooperation of production between the USSR and ChSSR for the period till 1990
by Ch. — one of the most industrially developed countries of the world was signed. Its specific weight in world industrial production makes apprx. 1,7% (a share of the population — apprx. 0,4%). For years of construction of socialism industrial output increased more than by 12 times. The leading industry — mechanical engineering (machines, electric locomotives, locomotives, rolling, power, chemical and other processing equipment). From 60th the chemical industry quickly grows. In light industry are most developed textile, shoe, glass, porcelain.
In agriculture of St. 95% of all grounds it is the share of the socialist sector. At the expense of own page - x. the needs for main types of food and raw materials for light industry are provided to products.
ChSSR actively participates in work of meetings of Ministers of Health of the socialist countries. The third (1958), the ninth (1967) and eighteenth (1977) meetings were held in ChSSR.
Natural movement of the population. Czechs make 64% of the population of the country, Slovaks — 31%, live Hungarians, Germans, Poles, Ukrainians. Average population density of 121 people on 1 sq.km (1985). The natural movement of the population (tab. 1) for 1920 — 1984
is characterized by decrease in birth rate (by 1,8 times). Due to the postareniye of the population the general mortality, as well as in the majority of economically developed countries, since the beginning of the 60th tends to growth. Child mortality for the same period decreased more than by 10 times. Continuously the average duration of the forthcoming life increased, reached edge in 1983 at men 66,9 years, women have 74,3 years (in 1937
it made at men — 54,9 years, women have 58,7 years).
Incidence. In structure of incidence in ChSSR, as well as in the majority of other economically developed countries, diseases of cardiovascular system, a respiratory organs, malignant new growths prevail. Diseases of bodies of blood circulation were the main reasons for death in 1982 (639, 5 on 100 thousand us.), malignant new growths (226,9), diseases of a respiratory organs (88,7), injuries and poisonings (73,4), diseases of digestive organs (46,3). Rate of mortality from inf. diseases made 5,4 on 100 thousand us. Among inf. diseases in 1982 on 100 thousand us. it was registered: scarlet fever — 184,
infectious hepatitis — 63,3, whooping cough — 1, a typhoid — 0,3. Diphtheria, poliomyelitis, trachoma are almost liquidated.
Organization of health care. Ch.'s health care has the state character. The right of the population for health protection is guaranteed by the resolutions of party and government of 1952 and the law of 1966 reflecting care about health of the people. All medical aid, including drugs and a resort therapy, became for the population free and public.
Responsibility for uniform nation-wide policy in the field of health care is conferred on Council for questions of health care. Ministers of Health of ChSR and SSR are its part, their deputies and other executives of both min.-century Min-va of health care of the republics exercise control of research in-ta, in-ta of improvement of doctors, medical information and statistics, high medical schools, resorts, the enterprises of pharmaceutical industry, distribution of medicines and other medical means, and also nek-ry special facilities. All other healthcare institutions are under authority of regional and regional national committees (PMC, RNA), and also regional (OINZ) and regional (RINZ) institutes of national health, exercising control of medical services in the respective territory. Powers of mines - in do not extend to medical service of Armed forces, railway medical service, expert activity in the field of social security, medical and pharmaceutical faculties, and also to the enterprises for production of the medical equipment and medical grants. These institutions are under authority of other min.-century.
Stationary and it is out-patient - the polyclinic help. The system to lay down. - the prof. of institutions consists of three levels: a)-tsy with policlinic
of the 1st type and other out-patient institutions, providing to the population (on average apprx. 50 thousand zhit.) help with all main medical specialties; b)-tsy with policlinic of the 2nd type, intended for the territories numbering 150 — 200 thousand zhit. These would render specialized types of medical aid, to-rye would not be provided with policlinic of the 1st type; they carry out also nek-ry tasks connected with training of average medical shots; c)-tsy with policlinic of the 3rd type, 1 — 1,5 million intended for service zhit. Most often such would be regional or clinical, providing the highly specialized help. In them a practical training for students will be organized and doctors improve skills. These large would form also base for research activity. The number of beds in hospitals increased since 1950 almost by 30%. Dynamics of security with beds in hospitals of ChSSR is presented in table 2.
Specialization of bed fund in the ChSSR medical institutions in 1983 is presented in table 3.
Management of extra medical institutions is constructed by the regional principle and includes 3 levels: first (regional), second (interdistrict) and third (regional).
The district clinic has, as a rule, 9 departments (therapeutic, surgical, children's, obstetric and gynecologic, dental, that berkulezno-pulmonary, dermatovenerologic, eye, otorhinolaryngological). Work in policlinic is organized but to the local principle. Now 1 medical site services on average 3346 inhabitants. In 1983 in out-patient and polyclinic institutions 222 million visits were made (14,5 visits on 1 inhabitant a year).
The policlinic of interdistrict type has 12 specialized departments (infectious, psychoneurological and orthopedic departments are added to 9 departments of policlinic of the 1st type). The policlinic at regional or university hospital having 17 — 23 the specialized departments treats the 3rd type.
Territorial out-patient clinics in the city are functionally merged into policlinic, but can exist and independently in certain residential areas. In them work the doctor of the general profile (therapist), the nurse, the pediatrician, the pediatric nurse, the obstetrician-gynecologist, the midwife-nurse, the dentist, the dental surgery nurse, and also the nurse of a geriatric profile. Both other medical and support personnel can be put into operation of such crew. The crew works by the local principle. The pediatrician services children up to 15 years. The obstetrician-gynecologist services female population of 4 — 5 medical sites. The doctor of the general profile gives medical help to workers of the small industrial enterprises, on to-rykh there are no special medical facilities.
In rural areas territorial out-patient clinics are located in large settlements. Recently there was a tendency to association 2 — 3 out-patient clinics in the centers of health. In the most remote areas medical points are created. In recent years great attention in work of territorial out-patient clinics and medical points is given to service chronically sick and aged. In ChSSR there are no independent clinics, their functions are performed by the relevant departments of hospitals with policlinics. The main out-patient and polyclinic service is provided with policlinics of the 1 and 2 types, and also wide network of territorial out-patient clinics, medical points at the industrial enterprises, women's and children's consultations.
In the country a lot of work on strengthening of material and technical resources of out-patient and polyclinic institutions, construction of new standard policlinics and out-patient clinics is carried out.
The Prague institute «Zdravpro-ekt» develops standard projects of rural local out-patient clinics. For adults it is provided from 1 to 3 offices for district doctors in out-patient clinics, as much for dentists; in the out-patient clinic servicing 3 sites the office of an obstetrician-gineko-log is provided. Besides, there are offices for specialists doctors, rooms for the patients expecting reception, service personnel and also household and auxiliary rooms. At an office of the dentist there is a room for a X-ray apparatus; the certain room for laboratory is provided in out-patient clinics. In out-patient clinics, servicing 1 — 2 site, medical and scheduled maintenance is carried out in the same rooms, but at different times. In the out-patient clinics servicing 3 sites the special offices intended for scheduled and sanitary and educational maintenance are allocated.
The project of improvement and rationalization of information systems of the Ministry of Health of ChSSR provides creation of an information system of the ambulator-but-polyclinic help (APP), edges are included by receiving and use for processing on the COMPUTER of the following data: a number of hours of work on 100 doctors, number of medical actions on 100 patients (on different specialties) and on working hour of the doctor, structure of operating time of the doctor (for different specialties) in the conditions of policlinic and at visit of the patient at home, data on incidence, number of doctors on a special
styam on 10 thousand population etc. These data will be consolidated in uniform bank in 1985 — 1990. Further the accounting of expenses on each type of treatment is provided.
In recent years in ChSSR much attention is paid to development of geriatric service and creation of hospitals for persons with hron. diseases.
Protection of motherhood and childhood. The exclusive attention is paid to health of mother and child. The legislation provided economic, social and medical actions for stimulation of birth rate, financial support to hmnogodetny families and on health protection of mothers and children. All working women have the right for issue in connection with pregnancy and childbirth with preservation of 70 — 90% of the salary within six months. Tax benefits are provided to families with children and allowances for each child are given. Medical aid to women and children is organized by the local principle. In 1983 to 1 medical position of the local obstetrician-gynecologist 6991 women, fell on 1 medical position of the local pediatrician — 1056 children aged up to 14 years (inclusive).
In all there would be obstetric gynecology departments (in 1983 16 505 beds, or 10,7 on YUOOOZHIT.), in the remote areas — maternity homes. Practically all childbirth takes place in healthcare institutions.
In all there would be children's departments (the number of beds in 1983 made 12 525). Besides, there would be specialized nurseries (4792 beds), children's homes (2423 beds) and houses of mother and the child (1998 beds); St. 22% of children under 3 years are provided with places in a day nursery (91 thousand places). In policlinics and out-patient clinics there are children's departments, at schools school doctors work.
Specialized medical aid to children is rendered by stomatologists, phthisiatricians, orthopedists, surgeons, psychiatrists, cardiologists-rheumatologists and other specialists. Vaccination of all children against tuberculosis, diphtheria, tetanus, whooping cough, measles, poliomyelitis, etc. is carried out. Thanks to efforts of bodies and institutions of obstetric aid and pediatric service in the country child and maternal mortality sharply decreased.
Health protection r and au h and x about m y ni lenny and r e d-p r and I am t and y. The leading direction continues to remain medical - a dignity. service of the working industrial enterprises. Constantly the network of factory medical institutions extends.
On large enterprises would be available with policlinic, on averages — policlinics, out-patient clinics, health centers (factory medical sites). The working small enterprises service territorial policlinics. In 1983 at the enterprises there were 2481 establishments of an ambulatory care (42 policlinics, 1087 out-patient clinics, 1352 health centers). In these institutions St. 4,5 thousand doctors worked, to-rye carried out 40 million surveys of workers. As district shop doctors the St. 2,5 thousand persons worked. In 1983 10 factory BCs with policlinic with total number of beds 2378 are organized.
331 C and N and t and r N about - epidemiological service. In
1951 the law on creation of hygienic and anti-epidemic service was adopted. In all areas and regions of the country SES are created. Chief health officers of the republics, regional and regional dignity. doctors direct activity of SES, exercise control of observance a dignity. - a gigabyte. and anti-epidemic norms; conduct researches of the environmental factors influencing health of the population, sampling of air, water, the soil and food stuffs for the analysis. SES carry out also tasks a dignity. inspections: give a dignity. permissions to functioning of economic and cultural and social objects, etc. In 1983 was 135 institutions a dignity. - epid. services, in to-rykh 1,2 thousand medical positions were held. In the country are available research in-you hygiene, occupational health and occupational diseases, epidemiology and microbiology. Are under authority of Czechoslovak academy of Sciences in-you microbiology, virology and parasitology. On all medical f-takh departments of hygiene, microbiology and epidemiology function.
Resorts. ChSSR is rich natural to lay down. resources. The resorts of Karlovy Vary (see), Mariánské Lázne (see), Frantishkovi-L of Asia (see), Pjeshtyani (see), Yakhimov (see), Esenik, Toeplitz (see), Trenchyanske-Toeplitz, etc. are world-renowned. In the country there are more than 50 resorts and more than 1300 mineral sources. In resorts in 1983 124 sanatoria on 34 648 beds functioned. Certain resorts and sanatoria are intended for treatment of cardiovascular diseases and rheumatism, diseases of a respiratory organs and digestion, psychological diseases, etc. Annually in resorts receive treatment apprx. 450 thousand patients. In ChSSR Ying t of phthisiology, balneology and climatology is created, to-ry carries out studying of mineral sources for the purpose of them to lay down. uses.
Health care workforce. In 1983 in ChSSR there were 54 thousand doctors, including stomatologists (35,0 on 10 000 zhit.).
For the end of 1982 in the country there was apprx. 7 thousand druggists, a St. 132 thousand paramedical staff.
Medical education. Preparation of medical shots is carried out by 10 medical faculties, on to-rykh study apprx. 11 thousand students. The annual release of doctors is made by 2300 — 2600 persons. One of f-tov prepares shots a dignity. doctors. On two pharmaceutical f-takh the St. 1,5 thousand students with annual release more than 300 specialists studies. Training on medical f-those — 6 years then the doctor within three years works in to lay down. establishment. After special preparation doctors undergo the certification of the 1st degree granting the right of independent work on the chosen specialty. Within the next 3 — 5 years doctors can finish special courses in in-those improvements of doctors, undergo certification
of the 2nd degree and have an opportunity to work as the chief physician to lay down. institutions. The paramedical staff in 1982 — 1983 academic year was trained by 77 medical schools (apprx. 30 thousand pupils, the St. 2,6 thousand people in absentia studied). For professional development of paramedical staff in Brno and Bratislava improvements of average medical shots function in-you.
Medical science. The Czechoslovak medical science is based on traditions of medical schools of large scientists-physicians, such as Ya. Purkinje, I. P of a rokhask, Ya. Yansky, Jedliczka (To. Jedlicka), Y. Tomayer, K. Pavlik, F. Spgud-nichka, etc. which scientific works gained popularity around the world. Ya. Purkinye (1787 — 1869) — the physiologist, the founder of experimental pharmacology was the largest scientist from their number. I. Prokhask (1749 — 1820) is a physiologist, for the first time formulated modern understanding of a nervous reflex, Ya. Yansky (1873 — 1921) is the author of the first classification of four blood groups. Problems of medical science are solved by 25 research in-ta of the Ministries of Health of ChSR and SSR, in to-rykh St. 5 thousand people, and also in-tam of system of Academy a spider work. On the basis of a medical f-tov in large a wedge, institutions also research centers function. In ChSSR several tens of science medical foundations work, to-rye since 1953 are joint in Czechoslovak medical about-in of Ya. Purkinye. In the country 41 medical magazines, including 9 — in foreign languages are issued.
the NATURAL MOVEMENT of the POPULATION of ChSSR FOR 1920 — 1984 (on 1000 people)
Table 2 SECURITY of the POPULATION of ChSSR with HOSPITAL AND SANATORIUM BEDS FOR 1948 — 1983 of
(on 10 000 people)
The Table 3 SPECIALIZATION of BED FUND IN the ChSSR And HOSPITALS SECURITY with IT of the POPULATION (for December 31, 1983)
Bibliography: Prokopets Ya. Development
of health care in the Czechoslovak Socialist Republic, in book: Socialism and zdravookhr., Probl. health and physical development of the person, under the editorship of
S. Ya. Chikin, page 226, M., 1981; Statistical year-book of member countries of Council of Economic Mutual assistance, M., 1983; CSSR zdravotnietvi 1983, Bratislava, 1983;
S t and with h J. Statistic^ setreni ve zdravot-nlstvi, Zdrav. aktuality, s. 172, 1971;
World health statistics annual 1984, Geneva, 1984. Ya. Prokopets.