Asia-Pacific Population Journal - Volume 21, Issue 1, 2007

The short answer to the question posed by the paper’s title is “no”, although any disease that kills millions should be combated with all the means available. I first addressed this question in an editorial in Social Science and Medicine a decade ago (Caldwell, 1995) and little has changed since then. That view is supported by the evidence found in major recent reports upon which this viewpoint is based (Stanecki, 2004; UNAIDS/WHO, 2004; USAID/US Census Bureau, 2004).

In September 2000, at the United Nations Millennium Summit in New York, leaders of the world’s Governments signed the Millennium Declaration and committed themselves to a series of goals and targets that came to be known as the Millennium Development Goals (MDGs). The Goals include reducing under-five mortality by two thirds (Goal 4) and reducing maternal mortality ratio by three quarters (Goal 5) between 1990 and 2015 (IMF, OECD, United Nations and World Bank Group, 2000). According to the assessment made in 2003 by ESCAP, UNDP and ADB, among 47 countries in the ESCAP region for which data are available, one half (24 countries) have already achieved Goal 4 and four additional countries are expected to achieve the Goal, leaving 19 countries (40 per cent) making slow progress or regressing. As for Goal 5 (improve maternal health), of the 42 countries for which data are available, seven have already achieved the Goal and another seven are expected to achieve it, leaving 28 countries (two thirds) either making slow progress or regressing. Goal 5 (reduction by three quarters) is more ambitious than Goal 4 (reduction by two thirds) and it is not surprising that fewer countries are progressing well towards the first than towards the latter. India is classified as progressing slowly towards Goal 4 and regressing in achieving Goal 5 as of 2003 (ESCAP, UNDP and ADB, 2005).

In his frequently quoted article, Coale (1973) proposes that one weakness of the demographic transition theory is that it indicates a high degree of modernization as sufficient to cause a fall of fertility, without indicating the degree of modernization that is necessary. By summarizing the findings of historical studies of European communities, Coale proposed three broad conditions necessary for fertility transition. He argued that modernization ultimately establishes these conditions, but that they can also occur in communities that have undergone little modernization. Lesthaeghe and Vanderhoeft (1998) later described the three conditions for fertility transition under the heading “readiness”, “willingness” and “ability”. Economic readiness means that fertility control must be advantageous to the actor so that fertility is within the calculus of conscious choice. Willingness means that fertility control must be legitimate and normatively acceptable. The basic question addressed by “willingness” is to what extent fertility control runs counter to established traditional beliefs and codes of conduct, and to what extent there is a willingness to overcome objections and fears. Ability refers to the availability and accessibility of contraceptive techniques. Similarly, Ahmed (1987: 363), applying Easterlin’s supply-demand theory of fertility observes that “studies on contraceptive use most often view three variables-motivation, attitude, and access-as the key determinants”. Motivation stems from having or expecting to have too many children or having them too soon. Although this has similarity with Coale’s notion of “economic readiness”, it does not necessarily capture whether fertility control is economically advantageous to an individual. In this paper the authors name Easterlin’s notion of motivation as simply “readiness” to distinguish it from Coale’s broader notion of “economic readiness”. Attitude refers to broad notions of acceptability of family planning in general and feelings about specific contraceptive methods in particular and is similar to Coale’s notion of willingness. Access or the “costs of fertility regulation”, as described by Easterlin (1975) pertains to the availability of contraceptives and selected services and is similar to Coale’s notion of ability.

To the Government of Singapore, the country’s declining marriage and fertility rates are serious national problems. It believes that those trends will have negative consequences for economic growth and Singapore’s overall quality of life in the future as Singapore faces a “greying population”. In 2003, there were 21,962 marriages registered, lower than 2002 (23,189), the 1990s (average 24,000) and the 1980s (average 23,000) (Singapore Department of Statistics, 2004: 14). Between 1970 and 1975, Singapore’s total fertility rate averaged 2.6; in 1980, it was 1.80; in 1986, 1.43; in 1990, 1.83; in 2000, 1.60; and in 2003, it had fallen to 1.24.1 During the same period, the population census also found that there was a higher proportion of Singaporeans remaining unmarried. In the Singapore Census of Population 2000, for the age group 30-34, one in three Singaporean males and one in five Singaporean females were unmarried (Singapore Department of Statistics, 2001: 2). The State is particularly concerned that Singapore’s future economy will be unable to sustain an ageing population, where 20 per cent of the population would be aged 65 and older by 2030 (Singapore Department of Statistics, 2002: 6).

International labour migration in Asia has experienced the most rapid growth in the last few decades. There are two major destination regions for labour migrants in Asia: Middle East and East and South-East Asia. In addition to countries of the Middle East, since the early 1980s we observe a sustained growth of foreign manpower in the prosperous countries of East and South-East Asia, particularly Singapore, Malaysia, the Republic of Korea and Japan. Those countries have followed specific temporary migrant worker programmes in recruiting foreign workers although the name and nature of the programmes vary. One can identify two types of temporary labour migration programmes implemented in the region – the “work permit” and the “trainee” programmes. Each migrant worker programme offers different rights and privileges to migrants. Malaysia and Singapore hire foreign workers under the “work permit” system, which provides special benefits to them as workers. But the Republic of Korea and Japan pursue a conservative policy with regard to the admission of foreign workers. They hire foreign workers mainly under the “trainee” system, which restricts benefits as trainees are not formally recognized as workers. In general, labour migration policies in the receiving countries in Asia can be broadly summarized as follows: limiting labour migration, limiting the duration of migration and limiting integration (Piper, 2004: 75).