This report encompasses material gathered in 1971 in Thailand, Sweden, and Israel. Observations of group care arrangements for young children, discussions with local program and research workers as well as review of relevant publications form the basis of the presentation. A substantial portion of five months in Israel was available for study of the kibbutz and its relationship to child care and development, while during shorter stays in Thailand and Sweden, child care arrangements were a focus of interest. The extensive experiences of the kibbutz and Swedish day nurseries will be emphasized since they are more applicable to present concerns in the United States.
On a national level, several factors are responsible for Sweden's leading position in achieving the excellent health of children because Sweden has experienced a long history of peace and success in establishing a parliamentary democracy throughout the 20th century. Among the different sectors of society, Sweden has been able to focus on prevention and health promotion. The Swedish health care system is publicly financed based on local taxation. Pediatricians working in secondary and tertiary care are employed by the public sector, whereas family physicians are employed by both the private and public sectors. The pediatric departments at county and university levels provide a high quality of inpatient care for neonates and children. The county hospital pediatric departments typically include one neonatal ward and one ward for older children. Subspecialization exists even at the county level, and there is close cooperation between the county level and subspecialist units at the university level. Within the primary care sector, most children receive care from family physicians. The majority of family physicians have completed 3 months of pediatrics in their basic training program. In the more densely populated areas there are also pediatric ambulatory care centers working mostly with referrals from the family physicians. Preventive care is carried out at midwife-led maternity health centers, nurse-led Child Health Centers, and nurse-led school health care settings and reach almost everyone (99%). All health care for children and adolescents is free of charge up to 18 years of age.