In Korea, where the total fertility rate remains at 0.75 in 2024―again, the lowest in the world―low-birthrate trends are increasingly becoming a structural crisis rather than a temporary phenomenon. Meanwhile, public perceptions are rapidly changing regarding marriage, childbirth, and childcare, revealing the need to reassess the validity of existing policies and reorient general policy directions. In response to these circumstances, the August issue of Health and Welfare Forum presents findings from the Survey on Marriage, Childbirth, and Childcare, which was conducted online with 2,500 men and women aged 20 to 49 in each of Germany, Japan, Sweden, and France, and compares these findings with results from the same survey administered in Korea. The survey examines perceptions across four key themes: marriage, childbirth, and gender roles; the division of responsibilities for housework and childcare; demographic shifts and society; and population policies and government spending. Going beyond simple cross-country comparisons of perceptions, our discussion places the sociocultural landscape and policy environment into perspective, exploring the limitations and potential of Korean society and drawing implications for future population policies. What makes our survey significant is that its findings, derived from the same questionnaire, allow for robust cross-country comparisons and, as such, can contribute not only to the diagnosis of trends but also to evidence-based policymaking. Efforts must continue in this direction, with regular implementation of cross-country surveys like the one on which we base our discussion, to monitor changing public perceptions and ensure that Korea’s policy orientation stays aligned with international trends.

This article compares perceptions of Germans and Koreans regarding several themes―including ‘marriage, childbirth, and gender roles,’ ‘division of housework and childcare responsibilities,’ and ‘demographic shifts, social structure, and policies’―and draws implications for population policies in Korea, using data from the Survey of Perceptions on Marriage, Childbirth, and Childcare, conducted in 2024 of 2,500 individuals from each of five selected countries. Both the prevalence of fertility intentions and the desired number of children were lower among Koreans than among Germans. Koreans also perceived greater difficulty balancing work with family responsibilities such as housework and childcare. Germans were more aware than Koreans of available childbirth and childcare support programs. Perceived levels of social trust and fairness were higher among Germans, while Koreans were more likely to agree on the need for improving social institutions overall. These findings suggest that policy measures intended to respond to low birthrates should be designed so that their impact is felt more broadly by the public. Furthermore, institutional support is essential to help individuals make full use of programs aimed at promoting work-family balance. It is also crucial that, when charting policy directions, widely held public perceptions and social values be taken into account, as they may influence individuals’ decisions about family formation and childbirth.

In this article, I compare the perceptions of the Japanese and Koreans about marriage, childbirth, and childcare, and examine how these two groups differ in their views on population issues. Marriage and fertility intentions were less prevalent among the Japanese than among Koreans. The Japanese regarded health and economic conditions as important factors in decisions about family formation and childbirth, while for Koreans potential career interruption was considered more significant. When it came to housework and childcare, there were discrepancies between the actual division of responsibilities and what was perceived as fair. More than half of participants in both Japan and Korea agreed on the difficulty of achieving work-life balance. Regarding childcare, a vast majority of participants in both countries viewed it as a responsibility shared by society and the family. Meanwhile, although Koreans were more aware than the Japanese of existing population policies, their perceived accessibility of available programs, especially paternal leave, was lower. Perceptions of marriage, childbirth, and childcare are, after all, not so much about individual choices as they are shaped by social structures in which various conditions―work-family balance, possibility of career continuation, and policy effectiveness―act on one another in interdependent ways. In this light, population policies down the line will need to be pursued in parallel with efforts to initiate changes at the social-structural level.

In this article, we make a cross-country comparison of perceptions of marriage, childbirth, and childcare, as well as acceptance of relevant policies, based on a survey conducted in 2024 with 2,500 Swedish adults aged 20 to 45 and the same number of Korean respondents in the same age range. For most survey items―including those on marriage and fertility intentions, desired number of children, awareness of existing policies, and perceived accessibility of available programs―responses were more positive in Sweden than in Korea. Attitudes toward marriage and childbirth were found to be more negative in Korea, possibly reflecting concerns about an uncertain future, fear of career interruption, and doubt about the effectiveness of government policy measures. Differences between the two countries were especially pronounced in levels of trust in population policies and perceived access to childbirth support. Disparities were also notable in perceptions of accessibility to parental leave, government budget allocations for population policies, gender roles, and the difficulty of balancing work, housework, and childcare. These findings suggest that raising Korea’s birthrate will require not only broader public awareness and acceptance of relevant policies, but also the development of effective policies and conditions conducive to work-family balance.

This article compares perceptions among French and Korean adults regarding marriage, childbirth, and childcare, and analyzes how these two groups differ in their views on population issues. The French gave greater weight to health, housing, and work-life balance in deciding whether to have and raise children, while for Koreans the most important factor was economic conditions. Koreans were more widely concerned that childbirth would lead to constraints on freedom and reduced work opportunities. Trust in society at large was higher in France, as was the prevalence of positive perceptions of government responses to population issues. Public awareness of population policies was generally higher among the French than among Koreans. The percentage of those supporting increased government spending on related policies was also higher in France than in Korea. These findings suggest that the development and implementation of population policies should be accompanied by improvements in structural social conditions and strengthened social trust.

This paper aims to provide policy directions to make Korea’s healthcare system and policies more person- and consumer-centered. My recommendations to achieve person- and consumer-centered healthcare system and policies include: 1)shifting paradigms in healthcare system and policies so that they become more person-oriented and person-centered, 2)creating conditions and foundations for shared decision-making in healthcare delivery and use, 3)strengthening consumer empowerment and participation, 4)establishing foundations and platforms to provide, share, and utilize health information and data, and 5)creating conditions for the active participation of healthcare providers.