Fertility rate, demographics, and socioeconomic outcomes: a scoping review

In recent decades, social and economic changes have led to a drop in fertility rates in various countries, including Malaysia. A persistent birth rate below the replacement levels will lead to demographic changes that eventually increase socioeconomic issues over time. Therefore, it is very important to get a comprehensive overview of this situation, one of which is to study factors that may influence public reproductive choice such as knowledge and perception about fertility rate. Given that both variables have the potential to impact individual decision, it is essential that the public grasp the connection between fertility rates and shifting trends in the country's demographic structure, particularly to preserve the nation's sustainability. This scoping review aimed to outline the existing studies addressing public knowledge and perception of fertility issues, particularly fertility rate and its relationship to population demographics. A systematic literature search was conducted through five online databases which are ScienceDirect, Scopus, SpringerLink, ProQuest and PubMed, targeting studies published between 2005 and 2025. An effective search strategy was developed using the PCC (Population, Concept and Context) framework, combined with Boolean operators to ensure a comprehensive result. The search terms used included (“knowledge” OR “perception” OR “understanding”) AND (“fertility rate” OR “total fertility rate” OR “national fertility rate”) AND (“demographic trend” OR “population trend”) AND (“public”). After a thorough screening of 982 articles, only 30 studies were selected for final review. Key themes identified across these studies include public knowledge and perception of fertility rate and policies, personal opinions and societal norms affecting childbearing, demographic shifts, healthcare system challenges and changes in support ratios affecting the economy. Subsequently, the study emphasises that a number of variables, beyond knowledge and perception, affect the fertility rate. It also stresses the significance of establishing a solid strategy for the future to address this issue, especially for the long-term health and security of the nation.