Given the fact that there has been a substantial demographic change in our world
environment, both in theory and practice, fertility and birth control are the most
important elements in the study of population dynamics. For many developing
countries the worries are about high fertility rates, while for other countries the
problem may be low fertility rates. The aim of international efforts for the first group
of countries is to reduce total fertility rates and bring them down to the
replacement level of two births per woman. However, the fertility rate has
continued to fall in nearly all populations that have reached the replacement level.
The Population Reference Bureau’s 2001 World Population Data Sheet shows that
65 countries and territories now have fertility rates that are below the replacement
level, including 40 out of 42 countries and territories in Europe. In over 20
countries, total fertility rates are below an average of 1.5 births per woman.
The Republic of Macedonia has experienced a substantive decline in fertility since
the onset of the socioeconomic transition. In one decade, the total fertility rate
declined from 2.2 in 1994 to 1.59 in 2002, and showed 1.47 children per woman in
2008. This number highlights the position of Macedonia in the group of countries
where fertility is below the level of replacement. It should be mentioned that to the
reproductive performance of the country, fertility levels and natural increase of
population, among particular population subgroups (by region and ethnicity) are far
beyond the level of fertility in the country (Jovanovic, 2005).
The rate of natural increase of the population has permanently been decreasing,
year by year. For example, from 1994 to 2008, natural increase declined from
15,772 to 3,963 inhabitants. For the same period, death rates increased (from
15,649 in 1994 to 18,982) and infant mortality rates declined (from 752 in 1994 to
223 in 2008, SSO, Natural population change, 2008, p.13).