Fourteen countries in Asia have total fertility rates at or below replacement level. This is more pronounced in China, Japan, the Republic of Korea, Singapore and Thailand. The implications are far-reaching and profound as they affect the age structure of the population, giving rise to population ageing, labour force shortages, increased elderly dependency ratios and feminization of the aged population. Evidence from European countries suggests that although fertility may rebound, in most countries it is highly unlikely that fertility will recover sufficiently to reach replacement level in the near future. Mortality reduction will continue to be an overriding policy goal, which would further enhance the ageing process. Therefore, the greatest challenge will be to pension systems, old-age care systems, and health systems or health insurance. This paper first examines the fertility transition in five low-fertility countries. It then discusses the policy measures that these countries have adopted in response to low fertility and population ageing. The paper concludes with the policy implications for healthcare, social care, income security and caregiving facility, and the scope for further study.

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