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We provide an overview on child health care in Czech Republic, including a historical background. Child health care has substantially improved in Czech hospitals during the past 20 years. Eight pediatric departments are located in university hospitals. The technical background of pediatric services meets high international standards. Inpatient and outpatient care is offered on a 24-hour service, and all pediatric subspecialties are usually provided. The different pediatric subspecialties are organized in the frame of the Czech Pediatric Society, and all of them have developed dynamic international scientific collaborations. From the organizational point of view, the formation of specialized centers of competence at university departments of pediatrics followed a mixture of a “bottom-up and top-down strategy” of all opinion and decision makers.