Social insurance was legally established in 1943, when the Social Security Institute was created under the Ministry of Public Health. The original law, providing for medical care and sick benefits, was modified in 1951, when health insurance became obligatory for salary and wage earners of any age who work under a written or oral contract and for apprentices not receiving wages. Legislation in 1973 authorized the institute to establish a pension plan. Self-employed persons and workers who have no contract of employment are not required to carry social insurance but may do so voluntarily by applying to the institute; coverage of foreign workers is compulsory. The program provides for free medical, surgical, and hospital care (not always available) for the worker and dependents, maternity care and cash benefits, sickness and accident benefits, retirement pensions between the ages of 55 and 60, and funeral benefits. Unemployment insurance does not exist, but severance pay is provided. Social security contributions amount to 9% of the gross salary withheld from the employee, 12% of payroll paid by the employer, and a government contribution equal to 1.5% of employee earnings.
Although women have full legal rights, in practice they face discrimination in education and employment, and their literacy rates are much lower than those of men. Domestic violence and sexual harassment remain serious problems for women and have been targeted as key issues by both the government and nongovernmental organizations. Spousal abuse is common and punishable only by a fine. The majority of women face harassment in the workplace.
Human rights abuses have diminished since the return to civilian rule and improvement continued after Luis Gonzalez Macchi assumed the presidency in 1999. International observers, however, have continued to cite the use of prolonged detention and the mistreatment of prisoners. The civilian government has taken some steps to punish those responsible for human rights violations during the Stroessner regime. Prison conditions remained poor, but nongovernment organizations were allowed to visit and monitor their conditions.