For the 5Th Asian and Pacific Population Conference

Singapore Country Report

for The 5th Asian And Pacific Population Conference

Executive Summary

Singapore, like many developed countries, is experiencing sub-replacement population growth. The Total Fertility Rate (TFR) was 1.60 in 2000. The government appointed a Working Committee on Marriage and Procreation to study the demographic trends which indicated rising singlehood, delay in marriages, delay in family formation, and sub replacement TFR. In addition, current obstacles to marriage and procreation show changing attitudes towards marriage, lack of opportunities to socialise and lack of social skills, financial cost, inability to balance between work and child bearing, and lack of suitable childcare arrangements. A package of measures was introduced aimed at removing the main obstacles couples faced in marriage and procreation. The success of the package of measures is unclear as its implementation coincided with the onset of an economic recession. Past evidence shows that there is a close positive correlation between economic performance and number of marriages and births. Thus, the full impact of the package of measures will not be known for some time.

In the last three decades, economic progress, improved housing and sanitation, clean drinking water and good public health services have contributed to the markedly reduced incidence of communicable diseases such as tuberculosis, diphtheria, poliomyelitis and enteric fever. Over the same period, our health care services have also improved dramatically. Today, Singaporeans are better informed about health issues, expect and receive good, affordable medical care and generally enjoy good health with high life expectancy. The rate of natural increase, increased from 8.3 per 1,000 resident population in 1999 to 9.2 per 1,000 resident population in 2000. There were 46,997 births in 2000, which was an increase of 8.4% from 43,336 births in 1999. The Crude Death Rate remained at 4.5 deaths per 1,000 resident population in 2000. Since 1960, death rates have fallen for all age groups. The total number of deaths increased marginally, from 15,516 in 1999 to 15,692 in 2000. The crude death rate maintained at 4.5 deaths per 1,000 resident population. The leading causes of death in Singapore continued to be cancer and heart disease. In 2000-2001, these diseases constituted more than 50% of all causes of deaths in Singapore.

In Singapore, the number of residents aged 65 years and over has increased significantly. In 1990, there were 164,000 elderly and they constituted 6% of the resident population. In 2000, their size increased to 238,000 or 7.3%. Overall, there were fewer men than women among the elderly population. This is largely contributed by the longer female life expectancy as compared with the male is a major contributing factor. With increased longevity, the old-old population (aged 85 years and over) increased at a faster pace than the overall elderly population. From 1990 to 2000, the old-old increased by 6.1% as compared with 3.7% for the elderly. Male had a slightly higher growth rate than females in both the elderly and old-old populations. Policies and programmes that need to be developed to provide support to the elderly population are wide ranging, and can be classified in the areas of healthcare, housing, income security, caregiving facilities and living arrangements.

The infant mortality rate and maternal mortality rates in Singapore are comparable to most developed countries. The government, as part of its national development programme, embarked on a family planning programme immediately after Singapore achieved independence in 1965. Besides the comprehensive provision of clinic services, the programme included a wide range of social and fiscal incentives to achieve a "two child" family norm. After a decade stabilisation of population growth, the government has replaced the policy in 1987 with a selectively pro-natalist "three or more if you can afford it" policy. Singapore provides a comprehensive tertiary to primary level adult gynaecological health services. At tertiary level, this also includes gynaecological oncology and urology. Singapore has achieved some major milestones for treatment of infertility in the past decade, including high IVF (in vitro fertilization) success rates. Reproductive Health Screening Programmes are offered at the primary and secondary care level and include breast and cervical cancer screening. The screening is offered at subsidised rates, at multiple centers across the island. There is a well-established referral system of positive cases to specialised centers for further evaluation and treatment. A screening registry to support tracking and recall of patients for screening is being developed at the national level. Adolescent reproductive health programme includes the school curriculum. AIDS education and involves NGOSs.

The first reported cases of Human Immunodeficiency Virus (HIV) infection in 1985. By 31 December 2001, 1599 Singaporeans were reported to be HIV infected. Sexual transmission was the main mode of transmission among Singaporeans, and accounted for 81% of HIV transmission among Singaporeans. The control and prevention of AIDS comes under the central control of the Ministry of Health, with the active involvement of all relevant government agencies and community groups to combat and control AIDS in Singapore. The National AIDS Control Programme was drawn up in 1985, and the main focus is on health education. The health education is targeted at the general population as well as those at risk of the infection. To further enhance AIDS education for persons at high risk of infection, AIDS education programmes are carried out for high-risk groups and the adolescent. Individuals who perceive themselves to be at risk of infection are encouraged to undergo HIV screening. Since early detection of the infection allows early treatment and care, facilities for anonymous screening are widely available. Counselling also provided at screening centres, as an opportunity for a change in lifestyle and risk behaviour. In Singapore, subsidised inpatient and outpatient care is accessible to HIV/AIDS patients. Patients are allowed to draw from their Medisave account for anti-HIV drugs that are registered in Singapore. HIV/AIDS patients who require additional financial or social assistance can approach NGOs or other charitable organisations for help.

Singapore is committed to women's empowerment and their full participation on the basis of equality. The basic rights of women are ensured through legislation, namely the Singapore Constitution, the Women's Charter, the Employment Act and the Penal Code. Meritocracy based on equal opportunities has been a key principle guiding gender equality in Singapore. Men and women are treated as equal partners in society and women are not marginalised or disadvantaged. Equal opportunities based on the principle of meritocracy has resulted in women naturally occupying important leadership positions in various spheres, as trade union leaders, youth leaders, Ambassadors, Members of Parliament, entrepreneurs, judges and more recently as Divisional Police Commander, Permanent Secretaries in the Civil Service, Commanders of army and air force units and President of the Association of Small and Medium Entreprises (ASMEs).

Infocomm21 is Singapore’s five-year strategic plan for harnessing Infocomm technologies to boost national competitiveness and improve quality of life for its people. To achieve widespread use of technology by Singaporeans, a three-prong approach is adopted - Increase Infocomm literacy, Improve access to Infocomm technology, and Encourage adoption of an e-lifestyle. Driving this movement is the Government’s vision of an e-inclusive society involving a tripartite partnership - the 3Ps representing the People sector (community groups and voluntary welfare organisations), the Private sector (commercial organisations) and the Public sector (government agencies). A three-year programme was also launched in 2000 to encourage Singaporeans to embrace an e-lifestyle, and Singapore is successfully narrowing the digital divide that exists between people of various ages, income levels, ethnic background and educational qualifications. Singapore has scored especially well in the area of Infocomm usage in Households. In year 2001, 64% of households have at least one computer. Internet connectivity grew quickly with 57% of households having Internet access in 2001. The adoption level of Infocomm technology has also increased among Singaporeans. Between 1996-2001, yearly surveys on Infocomm Usage in Households show that Internet access has grown steadily across different ethnic communities and income groups. More senior citizens and individuals with lower education are also beginning to use the Internet.

While Singapore has put in place affordable health care, housing and education for the general population, there is always a segment of the society who may fall into greater need. These disadvantaged families generally lack resources and family support and may need assistance to access basic services to support them through difficult times. A range of relief schemes/measures have been put in place to provide disadvantaged families help with basic subsistence needs, housing costs, health costs, child care services and schooling expenses. Under its "Many Helping Hands" approach, the government works together with voluntary, community and religious organisations to develop a network of social services to assist individuals and families in need. The overall emphasis is to help families falling into need to recover and become self-reliant over time.