Health Care for Children and Adolescents

in the USSR, a system of government and community measures ensuring the harmonious psychological and physical development of children and adolescents, the prevention of disease, and the lowering of mortality.

In the earliest days of Soviet power, a series of decrees on health care for children and adolescents was issued by V. I. Lenin; among them were On the Eight-hour Working Day [Oct. 29, 1917 (Nov. 11, 1918)], in which the labor of children under 14 was prohibited and adolescents under 18 were limited to a six-hour working day; the decree of Oct. 16, 1918, according to which all students were required to be under regular medical supervision in a dispensary; On Improving Children’s Nutrition (Sept. 14, 1918); and On Free Food for Children (May 17, 1919), according to whose provisions all children under 14, regardless of their parents’ social position, were issued free food. Among those playing an important role in the establishment of health care for children and adolescents were N. K. Krupskaia, A. M. Kollontai, and V. P. Lebedeva.

At first the task of health care for children was entrusted to the People’s Commissariat of Education. In 1917 the School Hygiene Department of the commissariat was established under the authority of the Bolshevik physician V. M. Velichkina (Bonch-Bruevich). The work of the school physician was defined, and the first prophylactic outpatient clinic for pupils and the first school sanatorium for children in poor health were set up. On July 11, 1918, the School Hygiene Department was renamed the Department of Health Care for Children and Adolescents and was transferred to the People’s Commissariat of Public Health. In 1921 the Council for the Health Care of Children was created in the department; the council was composed of members of the commissariats for public health and education. Of major importance in this system were children’s prophylactic outpatient clinics, which provided prophylactic, general medical, and other types of care in consulting rooms staffed by such specialists as phthisiologists, stomatologists, oculists, psychoneurologists, sports medical supervisors, and occupational consultants. The clinics also examined the health of a great many schoolchildren to ascertain their most prevalent illnesses and health irregularities and worked out methods for early diagnosis, treatment, and preventive measures. Also established at this time were dietary dining halls for schoolchildren, playgrounds in schools, sanatoriums for children with neuroses and tuberculosis, and forest schools.

The First Congress for Health Care for Children and Adolescents, held in March 1919, concentrated chiefly on problems of health care of schoolchildren and stressed the importance of preventive measures. Between 1917 and 1930, the foundations of childhood and adolescent hygiene were laid under the leadership of the hygienists and pediatricians D. D. Bekariukov, A. V. Mol’kov, A. G. Tseitlin, L. A. Syrkin, A. la. Gutkin, S. S. Poznanskii, E. P. Radin, and N. A. Glagolev. The Central Scientific Research Institute for Health Care for Children and Adolescents (now the Institute of Pediatrics and Pediatric Surgery) was founded in Moscow in October 1927. Later, analogous institutes were founded in such cities as Leningrad, Gorky, Kiev, Kharkov, Novosibirsk, and Rostov-on-Don.

In 1935 pediatric polyclinics were created; in 1949, together with pediatric consultation clinics, the polyclinics were united with pediatric hospitals or with hospital pediatric departments. Two systems of medical care for children merged: the system of health care for mothers and children and the system of health care for children and adolescents.

In 1963 consulting rooms for adolescents were established at polyclinics, large industrial enterprises, and industrial and technical schools. The consulting rooms’ medical personnel provide treatment and preventive measures for older schoolchildren, students at technical schools, and adolescents working in industry. Today’s labor legislation as a rule prohibits the employment of persons under 16.

There now exists a system of health care for children and adolescents in stages: pediatric polyclinics, physicians for schoolchildren and adolescents, dispensaries, general and specialized sanatoriums, and year-round and seasonal pioneer camps. The physical education of children and adolescents is carried on in general-education schools, youth sport schools, stadiums, and pioneer sports camps. Child and youth tourism is widely developed.

In 1959 the Scientific Research Institute of Childhood and Adolescent Hygiene was founded. The institute concerns itself with health problems of children and adolescents, with problems of health training and education in preschool institutions, schools, and vocational training schools, and with vocational orientation. In 1964 the N. K. Krupskaia Kharkov Institute of Health Care for Mothers and Children was revamped as the Institute of Health Care for Children and Adolescents. The Institute of Physiology of the Academy of Pedagogical Sciences of the USSR and a number of subdepartments in medical institutions of higher learning and physical-education institutes are studying sports medical supervision, the physiology of age evolution, and the methodological problems of training and education and of the physical education of youth.

A joint session of the Academy of Medical Sciences of the USSR (AMS USSR) and the Academy of Pedagogical Sciences of the USSR (APS USSR) took place in 1971. In 1972, the Scientific and Methodological Council of the AMS USSR and the APS USSR was organized and was named Health and School. The council coordinates the scientific research of physiologists, hygienists, pediatricians, psychologists, and pedagogues on basic problems of physical and mental development and the basic problems of the training and education of schoolchildren. The basic principles of the USSR’s system of health care for children and adolescents are accepted in all other socialist countries.