Health and social welfare in Communist Czechoslovakia can be defined by increases in maternity benefits, fluctuations in birthrate and abortion rate and decreases in factors such as infant mortality. The healthcare system featured an excess of bureaucracy, small-scale corruption, failing medical infrastructure, and outdated medical supply, while the social welfare system also fell behind in areas such as housing and nurseries.
Characteristics In the 1980s, Czechoslovakia had a comprehensive and universal system of social security under which everyone was entitled to free medical care and medicine. National health planning emphasized preventive medicine. Factory and local health care centers, first aid stations, and a variety of medical clinics supplemented hospitals and other inpatient institutions. The ratio of physicians to inhabitants had improved steadily, climbing from 1 per 745 in 1954 to 1 per 270 in 1989, although there were shortages of doctors in rural areas. The shift in the distribution of health resources in the 1960s and 1970s was dramatic; facilities were improved, and the number of health care personnel in Slovakia and rural areas increased in general. Despite the improvements, about 40% of all the medical equipment was obsolete, facilities were outdated and in short supply, the bureaucracy was excessive, and small bribery was widespread.
Spas Spas in Czechoslovakia were part of the health care system. In 1985 more than 460,000 people (5% of whom were children) stayed at the 35 spas in the Czech lands and 23 spas in Slovakia. Many spas had existed for centuries, such as Bardejov (since the 13th century) in Slovakia and Karlovy Vary in the Czech lands. Many of them specialized in the care and treatment of particular kinds of ailments. All had either mineral or hot springs, and some also offered mud treatments. In bygone days, the spas were frequented by European royalty and the wealthy, but in the 1980s they were open to all, including foreign tourists (who made up 10% of the patients in 1985). A number of people visited spas on vouchers provided by their trade unions.
Life expectancy In 1984 life expectancy in Czechoslovakia was 67 years for men and 75 years for women. In 1950 women's life expectancy was approximately 4.6 years longer than men's; by 1983 this difference had increased to nearly 7.5 years. While female life expectancy grew slightly, male life expectancy stagnated and in males aged 15, it increased. Infant mortality stood at 11.9 per 1,000 live births in 1988, down from 15.6 per 1,000 in 1975. As with medical care, the gap in life expectancy between the Czech lands and Slovakia was narrowed during this period.
Pensions In 1985 slightly more than one-quarter of the Czechoslovak population received some kind of pension; the elderly, the disabled, widows, and orphans were all entitled to assistance. Social security benefits (primarily retirement and disability) were equal for all wage earners. The average pension was less than Kcs1,000 per month (workers received an average pension of about Kcs 1,130, cooperative farmers about Kcs880, and independent farmers about Kcs720); this put pensioners among the lowest income earners. A substantial minority of the retired (23%) took up employment again to supplement their pensions.
Maternity and childcare benefits Women workers had a full complement of maternity and childcare benefits. Maternity leave (at 90% of full pay) was twenty-six weeks in the 1980s; an additional nine weeks were available for single mothers or for mothers having multiple births. Employers could not deny a woman's request for an additional year of unpaid leave for child rearing (without loss of job seniority). A system of child allowances and maternity grants also assisted women who took unpaid leave. Women were allowed three days of annual leave in case of illness within the family. There were substantial family allowances, in addition to direct grants, to single parents or families with handicapped children. An unmarried mother, widow, or divorced mother could not be fired if she had a child under three years of age; if she had children between three and fifteen years of age, her employer had to find her another job before dismissing her.
Facilities for younger children Nursery facilities for younger children were in very short supply; in 1984 they could accommodate less than 10% of children under five years of age. Beyond the sheer lack of space, nurseries were poorly distributed and were often concentrated in older centers rather than in new housing developments where young families were likely to reside. Kindergartens were in better supply, and a much higher percentage of children between the ages of three and six years attended these schools.
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