BY MUHAMMAD BASIR ROSLAN
KUALA LUMPUR: Malaysia is undergoing a significant demographic transformation, marked by a continuous decline in its fertility rates.
According to the latest demographic statistics released by the Department of Statistics Malaysia (DOSM), live births in Malaysia decreased by 12.3 percent to 100,645 in the third quarter of 2024 compared to 114,764 births in the same period the year before.
Similarly, the total fertility rate (TFR) declined from 2.1 children per woman aged 15-49 in 2010 to 1.7 children in 2023, well below the replacement level of 2.1. (The replacement level is the average number of children a woman must have to replace herself and her partner to ensure population stability in the absence of migration.)
This trend, according to experts, carries profound implications for Malaysia’s future. This is because a shrinking younger population due to falling fertility rates can lead to labour shortages, slower economic growth and increased pressure on social welfare systems to support an ageing population.
Health experts attribute this decline to a range of factors, including rising living costs, delayed marriage, urbanisation, shifting gender roles and evolving career aspirations among women.
The key questions to consider are the challenges Malaysia may face without substantial intervention and whether a holistic approach – integrating economic, social and health strategies – can effectively address these issues.
RISING COSTS OF PARENTHOOD
Dr Wan Hilya Munira Mustapha, head of the Reproductive Health Unit at the National Population and Family Development Board (LPPKN), opined that a key driver of this demographic shift is the rising cost of living, particularly in urban areas, which poses huge financial challenges in raising children.
“For example, in economically-driven regions like the Klang Valley, a household with one child spends about RM6,420 per month, while families in Alor Setar (Kedah) spend around RM5,130. These figures cover essential expenses such as housing, education, healthcare and daily necessities,” she told Bernama when met, recently.
She also noted that many young couples are choosing to delay or even forgo parenthood altogether due to the stagnant wage growth and limited support for childcare and family welfare.
Beyond economic concerns, societal shifts have also played a significant role in altering family dynamics, one of the most notable changes being the trend of delayed marriage.
“The average age of marriage for Malaysian women has increased from 23.5 years in 1980 to 28.1 years in 2020. This delay in marriage has a direct impact on childbearing as women who marry later often have fewer children due to the reduced reproductive window,” she said.
The reasons for this delay include women today prioritising higher education and career advancement and seeking financial stability and personal growth before committing to marriage and parenthood.
Cultural expectations around marriage and family life have evolved, with growing acceptance of individual choices and lifestyles.
“While these developments reflect progress in gender equality and personal autonomy, they also pose challenges to population growth as fewer children are born per household,” she said.
HEALTH, INFERTILITY ISSUES
Dr Wan Hilya Munira added that health concerns, particularly subfertility and infertility, further compound the decline in fertility.
Globally, infertility affects approximately one in six couples and Malaysia is no exception. According to LPPKN data, 60 percent of sperm analyses conducted between 2010 and 2019 revealed abnormalities, highlighting a significant rise in fertility issues among Malaysian couples.
Fertility issues often require medical intervention, which can be costly and emotionally taxing, putting additional pressure on couples who wish to conceive.
On concerns that Malaysia’s declining fertility rates is reshaping the nation’s demographic landscape, in line with DOSM’s projections that 17.3 percent of the population will be aged 60 and above by 2040, Dr Wan Hilya Munira said comprehensive policy reforms are needed to encourage higher birth rates and promote balanced family sizes. These policies must account for diverse socioeconomic contexts and provide equitable support for all families.
“The current initiatives from the government could be leveraged especially those related to financial incentives for parents, such as tax benefits, childcare subsidies and paid parental leave, to ease the financial burden of raising children. Complementary measures like affordable housing, quality education and accessible healthcare would create a family-friendly environment,” she added.
Flexible workplace policies, including remote work options and support for gender-equitable caregiving, could also empower families to grow while maintaining economic and emotional stability.
FAMILY PLANNING
Dr Wan Hilya Munira also emphasised the importance of family planning and access to contraceptive methods to address Malaysia’s demographic challenges.
She said family planning enables individuals and couples to make informed choices about when and how many children to have, contributing to healthier outcomes for mothers and children while reducing high-risk and unplanned births. It also ensures the family’s well-being and economic stability.
As for the use of contraceptives, Malaysia’s contraceptive prevalence rate (CPR) remained low at 42.8 percent as of 2022, and approximately 33 percent of women experienced unplanned pregnancies, according to the National Health and Morbidity Survey (NHMS).
(CPR is the percentage of women who are using or whose partners are using any form of contraception.)
This highlights a significant gap in family planning education and access, underscoring the need for enhanced public health initiatives to promote contraception.
Stressing the need for public health initiatives to combat stigma, misconceptions and limited access to modern contraceptive methods, Dr Wan Hilya Munira said enhanced education and equitable healthcare services are essential to bridging these gaps.
Meanwhile, family planning and health advocacy group Reproductive Rights Advocacy Alliance Malaysia (RRAAM) said family planning is often misunderstood as simply limiting the number of children in a family.
“Family planning should be looked at as a broader concept, allowing mothers, children and families to grow positively when they receive rights-based information and make informed choices in their lives.
“When people are able to plan when they want to have families – that is, when they are capable, when they are prepared – it directly and indirectly results in positive outcomes. Mothers can recover well from pregnancies and children are given the utmost attention, especially in their early years,” an RRAAM spokesperson told Bernama.
She said every individual should have access to information and services that enable them to decide if and when they want to have children and how many they wish to have, as well as the spacing between them. It also includes access to the full range of modern contraceptive methods.
“As a small grassroots organisation, we try to do our best to raise awareness on social media, while also conducting workshops like the CREATE Workshop, a two-day, hands-on, rights-based training programme to equip doctors and nurses with knowledge on contraceptive methods, including long-acting contraception,” she added.
Dr Wan Hilya Munira, meanwhile, said integrating family planning and birth control into demographic strategies is essential for sustainable population management.
“Contraceptive access also safeguards the future workforce, which is vital for Malaysia’s economic growth,” she said. – BERNAMA
