Answer for Oral Question PL199

QUESTION

Yang Berhormat Awang Zainol bin Haji Mohamed

YANG BERHORMAT AWANG ZAINOL BIN HAJI MOHAMED asked the MENTERI KESIHATAN to state the Ministry’s approach in addressing fertility and reproductive health issues among young couples, which are increasingly receiving attention, including in terms of early awareness, health examinations and access to appropriate treatment?

ANSWER

Yang Berhormat Menteri Kesihatan

Fertility and birth rates are challenges that involve not only health aspects, but also have implications for the country’s social, economic and demographic development. Therefore, the approach taken requires whole-of-government and whole-of-nation cooperation to create an environment that supports family formation and community well-being.

In this context, the Ministry of Health focuses on efforts to strengthen early awareness, reproductive health examinations and assessments, as well as access to fertility services and pre-pregnancy care.

Reproductive Health and Fertility Services: Early Awareness

The Ministry of Health, in cooperation with the Ministry of Religious Affairs, provides reproductive health education through the Pre-Marriage Course. This programme emphasises reproductive health, preparation for a healthy pregnancy, folic acid intake and healthy lifestyle practices. The programme reaches approximately 3,600 participants each year.

Health Examinations and Assessment

Prospective couples are encouraged to undergo health examinations and obtain pre-pregnancy advice before starting their family life. Couples experiencing difficulty conceiving, at least after two years of marriage, will be referred to an Obstetrician and Gynaecologist (O&G) for further assessment and management.

Fertility Services

The Ministry of Health provides various fertility investigation services within the public healthcare system, including hormone tests through blood tests, semen analysis, Hysterosalpingography (HSG), and laparoscopy and dye tests where required.

In terms of treatment, the Ministry provides appropriate clinical assessment, investigations and management, while cases requiring specialised treatment will be provided with advice and further referrals.

Demand for Fertility Services Is Increasing

The increased utilisation of services indicates that public awareness of reproductive health issues is growing. The number of Hysterosalpingography (HSG) procedures increased from 47 cases in 2022 to 226 cases in 2024. The number of semen analyses also increased from 218 cases in 2022 to 421 cases in 2024. Access to In Vitro Fertilisation (IVF) services continues to be strengthened to ensure that couples experiencing fertility problems have the opportunity to receive quality treatment, in line with efforts to improve the country’s reproductive health services.

National Fertility Rate Trends

The decline in fertility and birth rates is a trend receiving attention. The Total Fertility Rate (TFR) declined from 1.9 in 2021 to 1.5 in 2024 and 2025. The Crude Birth Rate (CBR) also declined from 15.3 in 2021 to 11.8 in 2024 and 2025. International experience shows that no single measure can address this issue; instead, it requires a comprehensive approach and sustained support for family institutions. The Government has also introduced various initiatives to support families, including the provision of deposit accounts for newborn babies.

Moving Forward

The Ministry of Health will continue to strengthen awareness of reproductive health, fertility examinations and assessments, pre-pregnancy care, and maternal and child health.

The Ministry’s objective is not only to help couples have children, but also to ensure that every couple has access to appropriate information, assessment and treatment to increase the likelihood of a healthy pregnancy and promote the well-being of mothers, children and families.

The Ministry of Health will continue to work with various government agencies and strategic partners to strengthen reproductive health and support efforts to improve family well-being in Negara Brunei Darussalam.

Through a comprehensive, evidence-based and people-centred approach, we hope to create a more conducive environment for the formation of healthy families, thereby contributing to sustainable national development and the aspirations of Wawasan Brunei 2035.