Analysis of the two-child policy's impact on the fertility level of the residents in Yangpu District, Shanghai / 上海预防医学

Objective To explore the impact of the two-child policy on the fertility level of residents in Yangpu District. Methods Birth registry data were collected from the residents of Yangpu District in Shanghai during January 2015 to December 2018 for the analysis of birth characteristics and its variation after the two-child policy implementation. Results The total fertility rate was higher than 1 only in 2016 that was 1.04, whereas it was about 0.8 in other three years. The number of the second child increased which was inspired by the policy. However, the increment in the number of second child was far less than the decrease in the first child. From 2015 through 2018, the proportion of second children in the total births with local household registration accounted for 18.84%, 20.03%, 26.29% and 24.35%, respectively. From January 2015 to August 2016, the proportion of second children was on the rise slowly, in which the annual percent change(APC)value was 0.34%(P > 0.05). From September 2016 to May 2017, the proportion of second children had shown an obvious increase, and the APC value was 3.97%(P < 0.05). From June 2017 to December 2018, the proportion of second children was on a downward trend, in which the APC value was -0.97%(P < 0.05). Conclusion Favorable fertility policy may not reverse the fertility level in Yangpu District, which remains at a very low level.

For making a declaration of countermeasures against the falling birth rate from the Japanese Society for Hygiene: summary of discussion in the working group on academic research strategy against an aging society with low birth rate

In 1952, the Japanese Society for Hygiene had once passed a resolution at its 22nd symposium on population control, recommending the suppression of population growth based on the idea of cultivating a healthier population in the area of eugenics. Over half a century has now passed since this recommendation; Japan is witnessing an aging of the population (it is estimated that over 65-year-olds made up 27.7% of the population in 2017) and a decline in the birth rate (total fertility rate 1.43 births per woman in 2017) at a rate that is unparalleled in the world; Japan is faced with a "super-aging" society with low birth rate. In 2017, the Society passed a resolution to encourage all scientists to engage in academic researches to address the issue of the declining birth rate that Japan is currently facing. In this commentary, the Society hereby declares that the entire text of the 1952 proposal is revoked and the ideas relating to eugenics is rejected. Since the Society has set up a working group on the issue in 2016, there have been three symposiums, and working group committee members began publishing a series of articles in the Society's Japanese language journal. This commentary primarily provides an overview of the findings from the published articles, which will form the scientific basis for the Society's declaration. The areas we covered here included the following: (1) improving the social and work environment to balance between the personal and professional life; (2) proactive education on reproductive health; (3) children's health begins with nutritional management in women of reproductive age; (4) workplace environment and occupational health; (5) workplace measures to counter the declining birth rate; (6) research into the effect of environmental chemicals on sexual maturity, reproductive function, and the children of next generation; and (7) comprehensive research into the relationship among contemporary society, parental stress, and healthy child-rearing. Based on the seven topics, we will set out a declaration to address Japan's aging society with low birth rate.

Governmental Policies for Overcoming Low Birth Rate by Country

The issue exerting the greatest influence in Korea is the low birth rate. It is important, therefore, to examine the countermeasures taken, and their effectiveness, by other countries suffering a declining birth rate and consequent aging population before Korea. Such countries can be categorized according to their cultural background: the UK, Continental Europe, Scandinavia, and Asia. In Continental European countries, such as Germany and France, the employment rate of women is relatively low, whereas it is relatively high in the UK and Scandinavian countries. In Asian countries, such as Japan and Singapore, despite many policies instituting the work-family balance, a childcare infrastructure, and child allowance, little is being achieved, due to the specific culture of Asia and the social rejection of various family forms. However, it should not be forgotten that those countries succeeding in increasing the birth rate have implemented continuous policies for decades.

The Related Factors of Willingness to Have an Additional Childbirth of Mother with Children in an Urban-Rural Area / 農村醫學 地域保健

OBJECTIVES: This study was conducted to investigate how willingness to have an additional childbirth was related to mother's general characteristics and various reasons for avoiding an additional childbirth. METHODS: By using organized questionnaire, we had face-to-face interviews with 722 mothers who had 12 to 36 months child in a urban-rural area of Chungcheongnam-do from 14 February to 19 February in 2005. Questionnaires included general characteristics composed of age, monthly income, number of children, major carers and mother's job status, and 6 reasons for avoiding an additional childbirth. We performed chi-square test and multiple logistic regression analysis. RESULTS: Of 722 mothers, 66.5% had no willingness to have an additional childbirth. In the multiple logistic regression analysis, old age of mother(95% CI of OR: 1.084-1.190), two or more children(95% CI of OR: 6.97-15.602) and weak norm about need for a child(95% CI of OR: 1.633-29.352) were independent related factors with willingness to have an additional childbirth. CONCLUSIONS: In our study, 2/3 women who already had children were appeared to have no willingness to have additional childbirth. Policies about family planning and controlling birth rate should be focused on eliminating barrier to additional childbirths.

Seeking a Better System for the Better Neonatal Care in Korea

Due to the decreasing birth rate and the increasing percentage of babies in need of neonatal intensive care, the Korean government has changed its policy to support the institutions that need neonatal intensive care units (NICU). In order to keep up with this change, it is critical to further publicize and educate the importance of neonatal intensive care and newborn baby care because it is the duty of our society to decrease the rate of neonatal death. The most likely reason for the sudden decrease of the neonatal death rate in Korea is probably the advancement of neonatology. Although the constant efforts by neonatologists to improve the quality of the treatment of newborn babies have decreased the neonatal death rate, the general support for neonatal intensive care is still insufficient, as a result of impractical medical fees and the shortage of health care providers for neonatal intensive care compared to in other developed countries. In conclusion, the support from the government through the increment of medical insurance fee is needed to improve the medical environment including neonatal intensive care, which, in turn, could secure general investment and international competitiveness.