The socioeconomic effects of international remittances are well documented, and the related literature is growing rapidly. Nonetheless, the impact of these inflows on fertility remains underexplored, particularly in countries that rely heavily on remittances. This study employs Method of Moments Quantile Regression (MMQR) to investigate the impact of remittances on fertility rates across nine selected countries in Asia, Latin America, and North Africa from 1990 to 2022. Our findings highlight two key points. First, the MMQR results indicate that remittances have a statistically significant negative effect on fertility across all quantiles, supporting the substitution effect. Second, this negative effect becomes more pronounced at higher quantiles, suggesting that remittances have a more substantial negative influence on fertility in countries with high fertility rates. A set of robustness tests confirms our baseline results.
This study investigates the spatial and temporal dynamics of population distribution in Mainland China from 1953 to 2020, using county-level data from seven national censuses. Integrating spatial analysis with time-series forecasting, it examines trends at national, regional, and county scales to assess migration patterns, concentration effects, and regional divergence. Results show that although the total population of mainland China increased over the past seven decades, the spatial pattern of dense settlement in the southeast and sparse settlement in the northwest, demarcated by the Hu Line, remained largely stable. The population centroid showed an overall southward shift, driven by eastern growth and northeastern decline, with eastern coastal agglomerations intensifying. Projections indicate population peaking at around 2020 and then declining to about 1.396 billion by 2030, alongside widening regional disparities: sustained growth in the eastern, stability in the central, modest gains in the western, and continued losses in the northeastern. The internal distribution has shifted from “multi-polar dispersion” to “coastal polarization”, producing a pattern of “southern growth, eastern concentration, western sparsity and northern decline”. These trends highlight the urgent need for region-specific policies to manage demographic decline and promote high-quality and balanced population development.
Highly educated workers play an important role in economic growth and productivity, yet gender wage disparities may persist even among workers with similar levels of education. This study examines the gender wage gap among highly educated workers in Vietnam, a rapidly growing market-oriented economy undergoing significant structural transformation. Using data from the 2018 Vietnam Household Living Standards Survey, the analysis applies Ordinary Least Squares regression and the Blinder–Oaxaca decomposition to investigate gender wage differentials. The sample includes 7167 working-age individuals who were continuously employed during the previous 12 months. The results indicate that highly educated women earn significantly lower hourly wages than similarly educated men. While differences in observable characteristics explain part of the gender wage gap, a substantial portion remains unexplained. The decomposition results show that approximately 44
The recent introduction of a national long-term care insurance (LTCI) policy marks a major institutional shift in China’s response to rapid population aging. Rather than representing a fully developed system, the current framework defines a three-year “establishment phase” during which core institutional arrangements are to be developed and refined. This study provides a system-oriented analysis of China’s LTCI, conceptualizing it as an integrated configuration of financing, governance, service delivery, and eligibility assessment mechanisms. Drawing on this analytical framework, the study examines key institutional domains that are likely to shape system development during the establishment phase, with particular attention to payment incentives, administrative processes, eligibility design, and service capacity constraints. It identifies a set of underlying tensions—between standardization and regional flexibility, formal service provision and informal care integration, and short-term expansion and long-term sustainability—that structure policy choices and may generate path-dependent trajectories. Beyond institutional design, the study highlights the broader implications of LTCI for care industry development, labor markets, and social organization. It argues that LTCI should be understood not only as a social insurance program, but as a dynamic system whose effectiveness depends on the alignment of its core components and its capacity for adaptive policy refinement.
Background: China’s demographic transition closely mirrors the global decline in fertility and the impending population aging in the 21st century. Consequently, China’s fertility policies have undergone drastic shifts to stimulate fertility. However, little is known about the national distribution of fertility intentions, the gap between intention and behavior, and how these trends have evolved alongside the nation’s rapid socioeconomic development over the past decade. Objective: To analyze the temporal trends and regional distributions of fertility intention and the gap between fertility intention and behavior across both genders in China from 2010 to 2021. Ultimately, this study aims to provide empirical evidence to assist policymakers in formulating future fertility policies and reproductive support systems. Methods: Data were drawn from the Chinese General Social Survey (CGSS) from 2010 to 2021, a nationwide repeated cross-sectional social survey using a stratified four-stage unequal probability sampling method. Fertility intention, behavior, and the congruence between the two were assessed. The annual trends were analyzed by calculating the annual percentage change and conducting nonlinear regression. Results: A total of 38,744 individuals across 28 provinces were involved in the analysis. From 2010 to 2021, the national rate of individuals with second-child fertility intention among the eligible population fluctuated around 75
Unmet need for contraception remains a major public health concern across Sub-Saharan Africa, with Benin reporting persistently high rates despite national efforts to expand access. This study investigates the ability of artificial intelligence (AI) algorithms to identify women of reproductive age most vulnerable to unmet need for family planning, using nationally representative data from the 2017–2018 Demographic and Health Survey (DHS). Among 6,669 eligible women aged 15–49, the prevalence of unmet need for contraception was 37.2
Vaccination remains the most effective global countermeasure against the COVID-19 pandemic. Exploring the underlying determinants of both vaccine uptake and hesitancy, particularly across distinct age cohorts, is essential for optimizing preparedness for future pandemics. This study examines age-specific patterns and determinants of COVID-19 vaccination and vaccine hesitancy in China, utilizing a nationally representative sample of 7,074 adults drawn from the 2021 Chinese General Social Survey. By the end of 2021, only 53.84
A population projection relies on assumptions that are considered to yield a realistic picture of the population’s probable future development. Six assumptions describe a future population: fertility, mortality, and migration for both men and women. However, in the formal or official female-renewal population projections regularly issued by governments and the United Nations, only women produce births, and the assumption about male fertility rates cannot be utilized. On the other hand, male-renewal population projections can be developed using the same method as that of female renewal, but they are unable to use the assumption about female fertility rates. Both projections impose the one-sex bias. The recently published two-sex renewal population projection could eliminate the bias, and it did so for the G7 countries in the conceptual scenario of constant vital rates and zero migration. To eliminate the bias in realistic scenarios, and with acceptable reasons, is a step from concept to practice. This step is also a challenge because the realistic assumptions about fertility rates are complex. Nevertheless, since women and men produce births jointly, there are reliable relationships between female and male fertility rates. Such a relationship is observed and explained by the two-sex stable population. Utilizing this relationship, assumptions of male and two-sex fertility rates are developed. Consequently, formal population projections can be upgraded from female renewal to two-sex renewal. Based on the male fertility rates and the formal female-renewal population projections of the G7 countries, this paper shows that the formal male-renewal population projection produces profoundly different medium, high, low, and zero-migration scenarios, revealing the one-sex bias in realistic scenarios. This paper also indicates how the two-sex renewal population projection utilizes all six realistic assumptions, upgrades the formal female-renewal population projections to two-sex renewal, and thus eliminates the bias in realistic scenarios. This upgrade does not require projecting two-sex fertility rates from scratch; it is built on efficiently utilizing the sophisticated assumptions of the formal female-renewal population projection and thus can be applied to more countries than just the G7.
In many developing countries, early motherhood is significantly associated with the risk to women’s health. Despite progress in women’s empowerment, healthcare, and education, early childbearing remains a persistent public health challenge in Bangladesh. This study investigates the associated socioeconomic and contextual factors of early motherhood in Bangladesh and categorizes them using a machine learning algorithm. The research employed a cross-sectional study design that incorporated data from the 2017–2018 Bangladesh Demographic and Health Survey (BDHS). From an initial target population of 20,127 ever-married women of reproductive age (15–49 years) residing in both urban and rural areas, a final analytical sample of 16,729 participants was established after excluding cases with incomplete information. The findings indicate that early childbearing is significantly associated with factors such as partner education, wealth status, living arrangements, educational attainment, and access to family planning services. Logistic regression, which outperformed other machine learning algorithms, was found to be the most reliable predictive model due to its superior Area Under the Curve (AUC = 0.8437). Based on these results, the government and non-governmental organizations should establish appropriate policies to delay reproductive age and anticipate future policy implications and fertility patterns, especially in emerging nations like Bangladesh.
Adolescent fertility is a significant indicator of reproductive health, gender equity and social development. While Türkiye’s total fertility has declined below population replacement level, regional patterns of adolescent childbearing remain insufficiently understood. To examine adolescent fertility trends across Türkiye’s 13 NUTS-1 regions from 2009 to 2024, quantifying rates of decline, assessing regional convergence, and exploring the relationship with total fertility. Regional fertility indicators were reconstructed using official birth registration and population data. We calculated adolescent fertility rates (AFR, per 1000 women aged 15–19), adolescent birth share (percentage of total births), and total fertility rates (TFR). Temporal trends were estimated using log-linear regression. Regional convergence was assessed through dispersion analysis and fixed-effects panel regression. National AFR declined from 36.6 to 9.9 per 1000 (annual percentage change [APC] = − 8.4
This study investigates the fertility gap in South Korea, defined as the discrepancy between the ideal and actual number of children. Using data from the 2021 Family and Fertility Survey, the analysis focused on 2217 married women aged 40 and older who reported no further childbearing intentions, thereby representing women who had completed their reproductive trajectories. Results indicate that while the average ideal number of children was 2.02, the actual average was 1.68, revealing a persistent shortfall between fertility aspirations and outcomes. Multinomial logistic regression showed that insufficient fertility was more common among women with lower incomes and those assigning high emotional or economic value to children, whereas stronger endorsement of patriarchal gender roles was associated with a lower likelihood of insufficient fertility. By contrast, excessive fertility intention was linked to stronger endorsement of individualistic family values, lower emotional valuation of children, and was less likely among economically active women. Taken together, the results highlight a paradox: the same structural and cultural forces that constrain some women from meeting their fertility ideals may also lead others to exceed them. This paradox underscores the limited autonomy and institutional support available for women to realize their reproductive goals. The study concludes that integrated policy measures—combining economic support, gender equality initiatives, and family planning services—are essential to narrow the fertility gap and address South Korea’s demographic challenges.
Against the backdrop of declining global fertility rates, assisted reproductive technology (ART) is increasingly critical in helping infertile couples achieve live birth. However, it is associated with elevated risks of preterm birth (PTB) and congenital heart disease (CHD). This population-based cohort study, comprising 115,553 singleton live births in Jing’an District, Shanghai (2013–2020), sought to quantify the impact of ART on PTB and CHD and to evaluate PTB as a potential mediating role, with a focus on early preterm birth (< 34 weeks). During the study period, the total number of births declined from 17,581 to 9,426, whereas the proportion of ART-conceived offspring increased from 1.46
This article aims to take stock of the situation of girls and women in China thirty years after the Cairo conference, at the very moment the Chinese government is actively taking measures to address the current low fertility rate—but at a time when girls and women are still exposed to gender-based discrimination in various areas. Rather than addressing all of the objectives set out in the Cairo Programme of Action, this article focuses on two specific ones: the fight against “discrimination on the basis of sex that still starts at the earliest stages of life” (chapter 4, part B) and women’s reproductive rights in relation to family planning (chapter 7, parts A and B). It first describes the legal arsenal that has been put in place since the 1990s to protect girls, with the aim of putting an end to sex-selective abortions and excess mortality among infant girls. It then assesses achievements in these two areas in the decades following the Cairo conference. In a second section, we briefly highlight the current demographic situation, showing that China now needs mothers in order to increase the birth rates—alongside a refocusing of social norms on traditional family values, which is encouraged by the government. We then take stock of the new paradigms regarding contraception and abortion that align with the government’s objective to increase fertility, showing that Chinese women now face competing pressures. Finally, we conclude that women may be exposed to increasing social and family pressure to have children and get married, suggesting that there is still a long way to go before they can achieve full autonomy in decisions regarding their reproductive lives in the context of the new birth-friendly policy.
Thirty years after the 1994 International Conference on Population and Development (ICPD) in Cairo, sexual and reproductive health and rights (SRHR) stand at a critical juncture. This commentary reviews the progress, persistent gaps, and new challenges since ICPD. It focuses on three main domains along the reproductive continuum: prevention and treatment of sexually transmitted infections (STIs), including HIV; infertility and assisted reproductive technologies; and pregnancies not ending in live births, including induced abortion, miscarriage, ectopic pregnancy, and stillbirth. Since ICPD in Cairo, scientific advances have transformed prevention and care. These advances have greatly improved population health and expanded reproductive options. However, their benefits are unevenly distributed. Socioeconomic inequities persist; marginalized populations are the least likely to benefit from innovation. Meanwhile, antimicrobial resistance, stigma, and underfunded health systems threaten sustainability. In infertility care, global disparities in access to services coexist with risks of over-medicalization and commercialization in some high-income settings. For pregnancies not ending in live births, restrictive abortion policies, ongoing stigma, and lack of recognition of miscarriage and stillbirth continue to undermine health, autonomy, and equity. Emerging pressures—including climate change, demographic shifts, and declining political and financial support to SRHR—put progress at risk. We argue that recommitment to the ICPD’s rights-based, human-centered framework is needed. The future SRHR agenda must combine scientific innovation with social justice, solid financing, ethical governance, and intersectional policy. Only then can we protect gains and prevent deeper reproductive inequalities.
While the impact of life course circumstances on later-life health is increasingly acknowledged, their specific contributions to healthy aging among Chinese older adults remain insufficiently understood. This study aims to quantify the contributions of key life course domains and identify which factors most significantly influence healthy aging outcomes. Utilizing data from the 2014 Life History Survey, the 2015 main wave, and the 2015 biomarker collection of the China Health and Retirement Longitudinal Study (CHARLS), Healthy Aging Scores (HAS) were constructed using Item Response Theory (IRT) models based on 29 items across seven dimensions. Ten domains of life course circumstances, spanning childhood to adulthood, were examined. Shapley Value Decomposition was used to quantify domain-specific contributions to HAS variance. Hierarchical cluster analysis and multivariable linear regression were also employed to explore subgroup patterns and associations. The ten life course domains explained 26.69
The preference for sons has been well documented in Nepal and is directly linked to reproductive health outcomes, such as the use of contraception. This paper examines the patterns of contraceptive use in Nepal and investigates the influence of son preference on contraceptive use among women with only daughters compared to those with only sons. The study analyzes data from the four most recent Nepal Demographic and Health Surveys (NDHS). Use of traditional contraceptives increased in both groups over the survey years but was not associated with the number of children for either group of women. In contrast, use of modern contraceptives was consistently higher among women with only sons than among those with only daughters across all survey years, indicating that women with only sons were more likely to use modern contraception. Fertility preference was another predictor of modern contraception use in both groups. Socioeconomic factors—such as women’s and husbands’ education, place of residence, caste and ethnicity, wealth status, and working status, also showed varying associations with modern contraceptive use across the both groups over the four survey periods. Despite declining fertility rates and improvements in women’s socioeconomic status in Nepal, son preference remains a key determinant for the use and non-use of any modern contraceptive methods for fertility regulation. Therefore, family planning programs must address issues of gender inequality.
Terrain slope is a pivotal environmental factor influencing population distribution. With China's rapid urbanization, urban and rural populations have been redistributed. However, the distribution and change of urban and rural populations across slope gradients in China remain underexplored. Using a digital elevation model and multi-temporal spatial population datasets, we conducted a comparative analysis of urban and rural areas to investigate population distribution and its changes across slope gradients in China from 2000 to 2020 at both national and provincial scales. Our results show that: (1) from 2000 to 2020, the pattern of 'urban increase and rural decrease' in population proportion generally occurred across all slope sections, and in every period for each statistical unit, the proportion of urban population always decreased with increasing slope; and (2) in most provinces, the urban and rural populations both maintained an L-shaped distribution across slope gradients. The mean slope of population distribution in both urban and rural areas tended to increase, although the mean slope for the urban population was generally lower than that for the rural population. These results provide new insights into population distribution and change characteristics in urban and rural areas. Our findings suggest that the influence of the slope factor should be fully considered when designing policies to optimize the spatial distribution of population.
