JSOG Presenter: Public Funding for Antenatal Care and Its Association With Perinatal Health Indicators in Japan [ID 1240]

INTRODUCTION: Japan faces declining birth rates yet maintains a low perinatal mortality rate (PMR) of 3.4 per 1,000 births, supported by feasible access to medical care. Pregnant women receive extensive care with 14 recommended antenatal visits, and the government provides financial support as part of its strategy to counter declining birth rates at the lowest total fertility rate (TFR) of 1.26. However, regional disparities exist in public funding, TFR, and PMR, and few studies have examined the relationships between these factors. METHODS: Using aggregated public data from the Ministry of Health, Labour and Welfare, and the Statistics Bureau of Japan, we analyzed public funding per pregnant woman, antenatal visits, and gestational week at registration in 2022. Correlations between public funding, TFR, PMR, and other perinatal statistics by prefecture were explored. RESULTS: Across the 47 prefectures, the funding per woman ranged from approximately $523.4 to approximately $971.7. No significant correlation between public funding and either PMR or TFR was observed across prefectures. Public funding was negatively correlated with stillbirth rate. Perinatal mortality rate was negatively correlated with birth rate and positively with neonatal mortality. Positive correlations with TFR included health care professionals and facilities, whereas negative correlations involved neonatal mortality, population, and various socioeconomic factors including average salary and the numbers of marriage and divorce. CONCLUSIONS/IMPLICATIONS: Public funding did not directly affect TFR or PMR, which were associated with socioeconomic indicators. Strengthening employment and social support for women, alongside financial aid, may yield more effective results in addressing Japan’s declining birth rate.