Figures show that Macau will have 4,344 newborns in 2022, a year-on-year decrease of 682, with the birth rate dropping to 6.4 per 1,000, a record low since records began in 1985. The median age of mothers giving birth to their first child is 31 years old, an increase of 0.9 years year-on-year.
In order to understand the declining fertility rate in recent years, our neighbouring city of Hong Kong has initiated a survey on the desire to have children and the reasons for not having children, and it has been concluded that Hong Kong women’s reluctance to have children can be attributed to the following reasons: financial pressure, pressure on housing, pressure on education, and influence on personal and career development, etc. In response to the above factors, the Hong Kong Government has implemented corresponding policies to encourage childbirth.
Singapore’s fertility rate reached a high of 5.76 in 1960, but in 1975, its total fertility rate dropped to 2.07 (i.e. below replacement level). As a result, the Singapore government introduced a number of fertility and child-friendly measures, including the Baby Bonus Cash Incentive Scheme, tax rebates, longer parental leave, childcare subsidies, government subsidies for companies to provide flexible work arrangements, preferential housing and support for assisted reproduction technology. As a result of the generous parental benefits, Singapore’s annual public expenditure on marriage and maternity support quadrupled to S$2.5 billion between 2001 and 2017. The United Nations has praised Singapore’s pro-life policies as “the most comprehensive” among Asian countries and regions.
There are already countries and regions that have implemented policies that target the decline in birth rate. The authorities should consider following the precedent of implementing ” child-friendly policies” to address several factors affecting women’s desire to have children. Apart from incentives such as higher bonuses for newborns, other complementary policies, such as priority in public housing application and subsidising enterprises to provide flexible work arrangements, can be adopted to enhance women’s willingness to give birth by increasing childcare benefits and protecting women’s rights and interests in employment.
In addition to implementing a comprehensive policy on maternity and related factors, there is also a need to optimise women’s health check-ups, such as breast cancer screening. Among the new cancers among women in Macau in the past 10 years, breast cancer has always taken the first place, and it can be said that it is the “No. 1 killer” among women, and the incidence rate among women even takes the first place. In Europe, the average age of breast cancer incidence is over 60 years old, while the incidence of breast cancer among women in Hong Kong and Macau is getting younger, and the peak of breast cancer incidence in the Mainland has even dropped to 45-49 years old. The earlier breast cancer is detected and intervened, the higher the cure and survival rates will be.
In addition to breast cancer, cervical cancer is the fourth most common cancer in women. The HPV vaccine is effective in preventing the infection and development of many cases of cervical cancer, and vaccination of men can also reduce the spread of the cancer. The HPV vaccine (cervical cancer vaccine) has been incorporated into the local vaccination programme and is available free of charge to local women under the age of 18. As the incidence of cancers such as breast cancer and cervical cancer is increasing and getting younger, prevention mechanisms should be put in place, such as free regular cancer screenings for women after they reach a certain age.
*Associação dos Trabalhadores da Função Pública de Macau
