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01 September 2025 | Country Update
Schools are newly required to provide menstrual products for free -
11 July 2025 | Country Update
Advances in vaccine reimbursement and the National Vaccination Strategy -
22 June 2025 | Country Update
Capitation payment for gynaecologists to improve access and preventive care -
19 June 2025 | Country Update
First-trimester combined screening as part of new prenatal care strategy (pilot project) -
25 February 2025 | Country Update
Aneurysm screening and Be Fit 24: Initiatives in the 2025–2035 National Cardiovascular Plan -
09 November 2024 | Country Update
Amendment to the Act on Specific Health Services and other regulations -
07 September 2024 | Country Update
Government Council for Public Health -
31 July 2023 | Country Update
Changes in public health protection -
30 April 2023 | Country Update
The organisation of preventive and early detection programmes -
03 February 2023 | Country Update
Reducing administrative burden and occupational medical examinations for those in non-risk professions
5.1. Public health
As of 2022, the main actors for public health in Czechia are SZÚ, the two regional institutes of public health and 14 RPHAs. These institutions are directly subordinated to and managed by MZČR and its Chief Public Health Officer, who is also a Deputy Minister of Health.
SZÚ conducts research, provides advice on methodology and drafts expert opinions on the safety of various products, including cosmetics, food supplements and other items of daily use. It also systematically monitors the impact of environmental factors on population health, helps to prepare legislation and harmonizes Czech legislation with EU norms. For disease prevention and health promotion, SZÚ focuses on epidemiological surveillance of important communicable diseases and on promoting healthy lifestyles (Czechia has a surveillance system for some 50 diseases and public health hazards). SZÚ also coordinates the different public health actors and supports their activities in a variety of ways, such as through the publication of educational materials.
The two regional institutes of public health (zdravotní ústavy) are in Ústí nad Labem and Ostrava, with branches in other cities; they were created following 2012 reforms out of the original 14 institutes of public health located throughout the country. Currently, they share some epidemiological surveillance duties with SZÚ, though their chief domains are science and research. These two institutes (and their branches) are also permitted to compete with private laboratories, though they primarily serve as reference laboratories. Regarding immunization logistics, the two institutes collaborate with primary care facilities, which are responsible for providing vaccinations and antenatal services.
RPHAs are responsible for public health services including certifications, authorizations and immunization logistics (along with the two regional institutes of public health). Any physician who diagnoses a communicable disease must inform the relevant RPHA, which subsequently reports total incidence levels to the Information System on Infectious Diseases, which is part of NZIS. Patients with certain communicable diseases, such as tuberculosis or viral hepatitis, must obtain treatment from hospital departments specially designated for this purpose. RPHAs played a key role in implementing COVID-19 restrictions, including quarantine requirements and local lockdowns.
Immunization rates for vaccine-preventable diseases are relatively high, reaching 97% for diphtheria, pertussis and tetanus (DPT), and hepatitis B, respectively, and 94.4% for measles in 2020 (OECD, 2022b). The compulsory child vaccination programme covers DPT, poliomyelitis, hepatitis B and Haemophilus influenzae, and measles, mumps and rubella. For the first six vaccines, the vaccination schedule changed from 3+1 to a 2+1 in 2018 (children up to a year should receive the first two doses with a break of two months; the third dose should be provided between 11 and 13 months). In parallel, the compulsory vaccination schedule for measles, mumps and rubella also changed (the first dose provided to children aged 13–18 months, the second dose postponed to the age of 5–6 years). Parents can be fined up to CZK 10 000 for not following the vaccination schedule if there are no medical reasons to exempt a child.
Vaccination against hepatitis A, tick-borne encephalitis and meningococcal disease is available upon request but is generally not covered by SHI; some HIFs offer full or partial reimbursement for these vaccinations as part of their own prevention programmes. Compulsory vaccinations and vaccinations for some vulnerable groups are covered by SHI (namely, vaccination against influenza for people aged 65+ and for patients recovering from organ transplantation). In terms of financing, all compulsory and all voluntary vaccinations (for specified groups: human papillomavirus (HPV) for 13-year-olds, rotavirus and meningococcal disease for babies, influenza for seniors and vulnerable individuals) are covered by SHI. As of 2020, meningococcal vaccinations for children up to the age of 1 year are covered by SHI. COVID-19 vaccinations have also been fully covered. Other preventive care services covered by SHI include:
- preventive examinations and screening programmes for children of specific age groups;
- voluntary periodic examinations by GPs (biennially), dentists (annually) and gynaecologists (annually); and
- cancer screening programmes – for cervical cancer (annually), breast cancer (biennially from age 45) and colorectal cancer (occult blood tests annually between ages 50 and 54, and biennially for people aged 55+, or colonoscopy examination once every 10 years).
Preschool facilities are not allowed to enrol children without documentation of all compulsory vaccinations that correspond to the age of the child and the vaccination schedule, if not exempted for medical reasons or due to lifelong immunity. The 2020 legislative amendment to Act no. 258/2000 Coll. extended the vaccination requirement to all child care facilities, including those organized by employers (“children groups”) and other types of facilities for preschool-aged children; violators are subject to a fine. This was aimed at reversing negative trends in vaccination uptake and to level regulation for all child care providers.
Laws prohibiting smoking in public places and regulating tobacco advertisements on radio and television were enacted in 1989 and 1995, respectively. Greater restrictions on tobacco advertising came into force in 2004, and a new law on tobacco and tobacco product control was enacted in 2005, further restricting smoking in public places. However, the full-scale ban on smoking in public places was only introduced in 2017, following years of discussions. The legislation extended the scope of smoke-free areas as stated in previous legislation and overruled several previous exemptions (Act no. 65/2017 Coll.); health care facilities including surrounding areas, all indoor facilities used for public entertainment and for other public events, and zoological gardens must be smoke-free. Furthermore, the 2017 law introduced regulation of the use of electronic cigarettes in public places. Gradual increases to the excise tax on cigarettes, cigars and other tobacco products began in 2020. Annual increases were approved through 2023: by 10% in 2020 and 2021, followed by 5% in 2022 and 2023.
The 2017 antismoking law also included restrictions on alcohol sales (banning the sale of alcohol at children’s events and from vending machines) and increased fines for violations. Excise taxes on alcoholic beverages and tobacco were also increased in 2020. The increase in alcohol taxes was motivated by their rising affordability: while the average wage rose by 50% between 2009 and 2018, the excise tax on alcohol had remained unchanged since 2010. The excise tax on 0.5 litres of 40% alcohol increased from CZK 57 to CZK 64.5, although this remained lower than in Germany and Poland (MFČR, 2019a).
Health 2030’s focus on public health lies with disease prevention, health promotion and protection, and increasing health literacy. Additionally, the National Recovery Plan, funded by the European Commission in response to the COVID-19 pandemic, plans for several investments in health, specifically for research and development, increasing health system resilience and strengthening cancer prevention and care in the period 2021–2026 (see Box5.1).
Box5.1
MZČR and MPSV are jointly responsible for occupational health and injury prevention, though occupational diseases are the responsibility of departments within RPHAs. Any measurements needing to be carried out as part of an investigation are conducted by accredited laboratories, usually run by the two institutes of public health and their branches. The National Register of Occupational Diseases is administered by ÚZIS.
In August 2025, the Ministry of Health issued an amendment to Directive No. 160/2024 Coll., on hygienic requirements for schools and childcare facilities, which will take effect from January 2026. The reform introduces a legal obligation for all toilets used by girls over the age of nine (including shared facilities) to be equipped with individually packaged menstrual products. The measure, developed in consultation with public health experts, paediatricians, school representatives, parents and NGOs, aims to improve hygiene standards, reduce school absenteeism linked to menstruation, and promote equal access to education. While many schools already provide menstrual products on a voluntary basis, the directive establishes a uniform framework nationwide.
Czechia applies one of the highest VAT rates on menstrual products in Europe, at 21%. Despite the 2023 VAT reform, these products remained classified in the highest VAT category.
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From 2026, vaccine reimbursement in Czechia will follow a more predictable and systematic process, removing the need for legislative amendments each time a new vaccine is introduced. This reform is expected to improve access to modern vaccines. Under the amended Act on Public Health Insurance, the State Institute for Drug Control (SÚKL) will determine the level and conditions of reimbursement for immunization-related medicinal products through a formal health technology assessment (HTA) process. HTA will consider medical, social, economic and ethical aspects, along with the broader public health impact of each vaccine.
To support better access and uptake of vaccines, the Ministry of Health also submitted a draft of the country’s first comprehensive National Vaccination Strategy for internal consultation in July 2025. The strategy addresses the full vaccination life cycle – from vaccine approval and reimbursement to communication with the public and healthcare professionals and evaluation of the immunization programme. Aiming to improve coordination, transparency and public trust in vaccination, the strategy is expected to be approved by the government by the end of 2025.
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In February 2025, the Ministry of Health introduced a new National Cardiovascular Plan for 2025–2035 to strengthen prevention and reduce the proportion of Czech residents with heart and vascular diseases. This emphasis on prevention includes new screening options and the promotion of healthy lifestyles. As such, a new screening for abdominal aortic aneurysms and the “Be Fit 24” program have been launched, fully covered by the health insurance funds. The plan also includes new guidelines supporting the effectiveness of GPs’ preventive examinations.
The new screening program for abdominal aortic aneurysms started on 1 January 2025. It is intended for men aged 65–67 and can be joined via their GPs. Its goal is to detect aneurysms early and collect key data that will make health statistics more accurate.
Be Fit 24 is a program promoting healthy lifestyles in overweight children aged 6–11. The goal is to reduce their BMI by 5% within one year. Eligible children can enrol via their paediatrician. Each child participating in the program receives a free Garmin Vivosmart 5 fitness tracker and access to a mobile app similar with game-like features. This app allows children and their parents/guardians to track daily physical activity, energy intake and daily activity, and achievement of healthy eating and exercise goals. If a physician is not involved, a free fitness bracelet will not be provided, though the mobile app can still be downloaded. A new educative web also informs about nutrition, exercise and obesity prevention, where parents/guardians and children can get practical advice and tips on lifestyle changes (https://www.nzip.cz/bf24).
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In November 2024, the government approved an amendment to the Act on Specific Health Services (No. 373/2011 Coll.) and other regulations. This motion now has to pass through the Chamber of Deputies and Senate (in both, the government coalition currently holds the majority) and be signed by the president to be effective.
Among the main changes to the Act on Specific Health Services is the cancellation of some mandatory medical examinations. The goal is to reduce the administrative burden of both general practitioners, bring financial savings from decreasing the necessity of medical documentation extracts, and bring time savings to all participants. The cancellation concerns:
- the assessment of medical fitness for high school education, unless health limitations exist for the programme,
- annual medical fitness certificates of non-professional athletes who, for example, attend training in a sports club once a week, and
- entrance occupational medical exams for professions in the first (“without-risks”) category; however, both the employer and the applicant may still require the entrance medical examination.
The amendment further develops the new concept for health promotion programmes: combining protection against occupational and civil risks. Voluntary health support programmes are proposed, the purpose of which are to motivate employees to undergo preventive examinations and take care of their health.
Other changes will occur in the areas of assisted reproduction, protective treatment, genetic examinations, among others.
In a proposed amendment to Act No. 258/2000 Coll., on the protection of public health, changes apply to the self-employed in Czechia. Those classified self-employed in the area of accommodation services and epidemiologically significant activities (for example, hairdressing, massages, pedicures, etc.) should no longer be obliged to apply for approval of their operating regulations by the regional public health authority.
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On 4 September 2024, the Czech Government approved the establishment of the Government Council for Public Health, which will focus on promoting healthy lifestyles (disease prevention, health risk and biological monitoring). As public health is not something that the Ministry of Health deals with alone, the council will be composed of relevant ministries, departments, and agencies; associated public health authorities; and professional bodies.
The Minister of Health will chair the council, the vice-chair will be the chief hygienist and the secretary will be the director of the Department of Public Health Protection of the Ministry of Health. Other members of the council will be the senior director of the Science, Research and Innovation Section of the Office of the Government of the Czech Republic, the director of the Radiation Protection and Crisis Management Section of the State Office for Nuclear Safety, the director of the State Health Institute, the chief hygienist of the Ministry of Defense, representatives of the Office of the Government, the Association of Regions of the Czech Republic, the Union cities and municipalities of the Czech Republic, the Chamber of Commerce of the Czech Republic, the Association of Industry and Transport of the Czech Republic, the Agency for Medical Research, as well as representatives of the academic environment and professional medical societies.
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At the end of May 2023, Act No. 167/2023 Coll., amending Act No. 258/2000 Coll., on public health protection, and related acts, passed the legislative process. This amendment stipulates, among others, the following:
- From 1 July 2023, irregular vaccinations can also be administered by providers in the fields of hygiene and epidemiology, complementing providers that already offered these (those in infectious medicine, general medicine for children and adolescents, general medicine or providers of occupational medicine services and health institutes) (Act No. 258/2000 Coll., on public health protection, as amended).
- Also from 1 July 2023, workers who come into direct contact with food no longer need health certificates issued by physicians (Act No. 146/2002 Coll., on public health protection, as amended).
- From 23 October 2023, heated tobacco products with a characteristic flavour are prohibited, just as cigarettes with a characteristic flavour and tobacco intended for hand-wrapping cigarettes with a characteristic flavour (Food and Tobacco Products Act No. 110/1997 Coll., as amended).
- From 1 January 2024, statutory health insurance in Czechia will fully cover vaccination against HPV for all individuals aged 11–15 years. The above-stated amendment broadens the age range that was previously set at 13–14 years. Similarly, the age range for meningococcal vaccinations will be broadened from 14–15 years to 14–16 years (Health Insurance Act No. 48/1997 Coll., as amended).
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Act No. 167/2023 Coll., amending Act No. 258/2000 Coll., on public health protection, and related acts
Health Insurance Act No. 48/1997 Coll., as amended
Act No. 258/2000 Coll., on public health protection, as amended
Food and Tobacco Products Act No. 110/1997 Coll., as amended
Act No. 146/2002 Coll., on public health protection, as amended
Current preventive and early detection programmes cover nearly the entire population in Czechia. To ensure the high cost-effectiveness of these programmes and achieve the maximum positive impact on the population’s health, preventive programmes from 2023 onwards will be coordinated within the National Screening Centre of the Institute of Health Information and Statistics of Czechia (ÚZIS).
On 27 April 2023, the Council of the National Screening Centre met for the first time and discussed the management of the existing screening programmes for colorectal, breast and cervical cancer, as well as the lung cancer early detection program launched in 2022. The Council also supported preparing the prostate cancer early detection program that could start in 2024. Thanks to the Operational Programme Employment, ten new preventive programmes are ready for implementation, and another ten will be piloted in the coming years.
The preventive and early detection programmes do not relate only to cancer. There are ongoing programmes such as newborn laboratory screenings, pilot population screening programmes for spinal muscular atrophy and severe combined immunodeficiency in newborns and others.
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Ministry of Health. Press release 28 April 2023. “Byla ustavena a poprvé zasedla Rada Národního screeningového centra. Bude řídit podporu programů prevence a časného záchytu vážných onemocnění.” [The Council of the National Screening Centre was established and met for the first time. It will manage the support of programmes for the prevention and early detection of serious diseases.] https://www.mzcr.cz/tiskove-centrum-mz/byla-ustavena-a-poprve-zasedla-rada-narodniho-screeningoveho-centra-bude-ridit-podporu-programu-prevence-a-casneho-zachytu-vaznych-onemocneni
As of 1 January 2023, periodic occupational medical examinations are no longer obligatory for employees in non-risk professions (as defined in Public Health Protection Act no. 258/2000 Coll.). From now on, these examinations will only be performed upon the request of either the employer or the employee. The Ministry of Health agreed upon this with the Czech Chamber of Commerce and the Confederation of Industry of the Czech Republic. The policy change is defined in Directive no. 452/2022 Coll. amending Directive no. 79/2013 Coll. on occupational health services and certain types of assessment care. The provision of periodic examinations remains mandatory for defined “risky” professions. Entrance medical examinations also remain mandatory for all employees.
According to the Czech Minister of Health, this should not only lead to a reduction in administrative burden but also to annual savings of hundreds of millions of crowns on the part of employers and significant time savings for physicians and employees. The Ministry of Health will continue cooperating with employers to maintain quality care for employees by supporting prevention without redundant bureaucracy.
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References
Public Health Protection Act no. 258/2000 Coll., as amended
Directive no. 452/2022 Coll. amending the Directive no. 79/2013 Coll. on occupational health services and certain types of assessment care
Ministry of Health. Press release 20 December 2022. “Ministerstvo zdravotnictví ruší povinné periodické pracovnělékařské prohlídky u nerizikových profesí.” [The Ministry of Health cancels mandatory periodic occupational medical examinations for non-risky professions]. https://www.mzcr.cz/tiskove-centrum-mz/ministerstvo-zdravotnictvi-rusi-povinne-periodicke-pracovnelekarske-prohlidky-u-nerizikovych-profesi