Preventive care and early detection are considered critical and yearly checkups are recommended for everyone. Most preventive services are free such as annual checkups and maternal and child care. Compulsory vaccinations, physical examinations and dental checkups are carried out in schools for free. Free health checkups, screenings, vaccinations,procedures, nutrition, lifestyle, are offered at the fair. Expectant mothers and children could receive health checkups and health advice. Skunks also need to have regular yearly checkups. He was also given medicine and medical checkups during visits. During the rule of Kim Il-sung, effective mandatory health checkups and immunization programs were initiated. Hale continues to have quarterly checkups with her doctors. Regular checkups are recommended to monitor the health of the heart valves and the aorta. He regularly returned to the hospital for checkups and treatment through Dr. Estanga. There were several stages of army protection including thorough checkups. Returning to work within 12 weeks was also associated with fewer regular medical checkups. The machines need regular checkups and have to be adjusted every now and then. There has been pressure placed on the healthcare system as demands for medical checkups increase.