Letter to Editor

The Future of Iran with a Decrease in the Total Fertility Rate

Cite this article as: Azarbakhsh H, Dehghani SP. The future of Iran with a decrease in the total fertility rate. Arch Iran Med. 2025;28(4):255-256. doi: 10.34172/aim.33643

Dear Editor,

Demographic policies in any country are considered the basis of socioeconomic development.¹ These policies include all demographic trends, morbidity and mortality, reproduction and family formation, distribution, immigration, and, generally, the size and structure of a country’s population.¹ Fertility rate is one of the factors affecting population changes, and total fertility rate (TFR) is the most important indicator for its estimation, which is defined as the average number of children per woman during her reproductive life.² Iran has experienced one of the fastest declines in fertility. The observed pattern is a pattern in which fertility has decreased in all age groups, in all geographic locations, and in all social groups simultaneously; hence the rate of decline is considered at the national level.³

The global TFR has declined over the past seven decades and has experienced a steady decline since 1950. TFR was 4.97 in 1950, 4.40 in 1970, 3.18 in 1990, 2.72 in 2000, and 2.31 in 2019.⁴ TFR in Iran was 6 in 1974, 5.6 in 1985, 5.2 in 1988, 2.8 in 1995, 2.6 in 1996,⁵ and reached 1.8 in 2011.⁶ Based on the average fertility variable, Iran’s natural growth rate will decrease to almost zero percent in 2045-2050. In addition, it is expected to decrease to less than zero percent from 2050 onwards.⁷

The decrease in the overall fertility rate in Iran will have many consequences in the coming years, including changes in fertility behaviors and the realization of a small ideal family, increasing the age of marriage in men and women, changes in the age structure of the population, and aging of the population,⁸ shortage of the labor force, an increased disabled population and the needs of this population for care, an increase in non-communicable diseases and the need for diagnostic and treatment facilities due to the aging of the population, the decrease in the resilience of parents and children, reduced consolidation of the family foundation, reduction of family support for the elderly, lack of economic growth and development, moral and educational damages, disturbance in the social communication skills of children of low-population families, mental and psychological problems of the future generation due to not benefiting from the social gifts of kinship (including brothers, sisters, uncles, and aunts), forced migration and cultural disintegration of the destination country and the reduction of the country’s young and elite population.

Given the decreasing trend of the TFR and the aging of the population in Iran, the following are recommended

1. Reducing infertility treatment costs;

2. Improving economic conditions and reducing unemployment;

3. Strengthening job and financial security;

4. Social support for women to have children and creating suitable working conditions during pregnancy;

5. Reducing the distribution of contraceptives;

6. Culturization and educating people about the consequences of single-childhood;

7. Planning and educating toward facilitating marriage, lowering the age of marriage and strengthening the family;

8. Improving the physical and mental preparation of young people for raising the next generation and pregnancy;

9. Providing financial incentives and banking facilities to families with children.

References

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