Leading Japan in Childcare Support Policies:

Tottori Prefecture

Expanded and Improved Fertility Treatment
Costs Assistance; Free Postpartum Care; andHigh School Travel Expenses Assistance
Background and Reasons for Deciding to Undertake

Assistance for testing costs is provided as anthe Project

incentive for beginning fertility treatment early, asSince the founding of the “Child Care Kingdom

well as a means of lessening both the economic

Tottori” in 2010, Tottori Prefecture has been leading

burden of infertility testing costs and anxiety

Japan in undertaking childcare support initiatives

about infertility.

such as providing free nursery care for a family’s third(1) Infertility testing expenses assistancechild and assistance with paediatric medical*First government body in Japan to subsidise theexpenses in cooperation with local municipalities.

entire cost of testing)

As a result, the prefecture’s total fertility rate,

Subsidisation of the full cost (up to 26,000

which had fallen to as low as 1.43 in 2008, isyen) of testing costs not covered by healthrecovering and has remained in the 1.6 range for

insurance for married couples who have been

seven consecutive years since 2013. However, themarried for less than three years, or when thedesired birth rate (1.95) has not been achieved, withwife is less than 35 years of age.

the number of births continuing to decline year-on-(2) Artificial Insemination Subsidy Programmeyear.

*Highest subsidy amount in Japan

Accordingly, in response to prefecture residents

Subsidisation of 70% (up to an amountsaying that the burden of childcare is enormous, inequivalent to the amount covered by insurance)

FY2020 Tottori Prefecture newly launched a projectof the cost of artificial insemination undertakenthat pushes prefectural childcare support a stepwhen the wife is less than 35 years of age.

ahead of the rest of the country.

(3) Specific Fertility Treatment Expenses Subsidy
Programme

Project Aims
In order to achieve the desired birth rate (1.95) by
2030, the project aims to develop childcare support
that is appropriate for “Childcare Kingdom Tottori” ingoing a step beyond the rest of the country and that“lessens the economic burden of households withsmall children” and “lessens the physical and mental
burden of pregnancy, childbirth, and childcare”.

*Highest subsidy amount in Japan
Substantial expansion and improvement ofprefecture-managed assistance for a specificfertilitytreatment(invitro

fertilisation,intracytoplasmic sperm injection)(4) Recurrent Pregnancy Loss Medical Costs Subsidy
Programme
Assistance with testing and treatment for

Project Outline

recurrent pregnancy loss

1. Programme Supporting Desired Pregnancy andChildbirth (Expansion and improvement of

2. Postpartum Mothers and Babies Health Subsidy

fertility treatment costs assistance)1

Programme

Project Features and Innovation(1) Free postpartum care

Questionnaires asking prefecture residents about*First government body in Japan to make out-of-

measures to address the declining birth rate werepocket payments free of charge

conducted; measures were formulated based on

In order to support a smooth start to childcare

respondents’ sense of burden regarding childcare

in addition to preventing postpartum depression

and childcare support policies they want improved;and child abuse, Tottori Prefecture has madeand Tottori Prefecture and local municipalities

users’ out-of-pocket payments for postpartum

worked in collaboration to create, expand, andcare programmes (usage fees) free of charge inimprove systems that are a step ahead of the rest ofcooperation with local municipalities.

Japan.

(2) Expansion of (accommodation-type) postpartum
care providers by improving maternity home

Results of the Project

facilities/equipment[Expansion and improvement of fertility treatment

Subsidisation of costs for the extensions andcosts assistance]
・ Testing expenses assistance approximately

renovations necessary for creating maternity
homes with beds.

doubled.
・ First-time artificial insemination or specific

3. High School Travel Expenses Subsidy Programme

fertility treatment assistance also increased.
・ Testing is becoming an entry point for early*Only system in Japan with “no limitations onincome” for eligibility

treatment.

So that high school students need not abandon[Free postpartum care]・Project led to a large increase in mothers utilisingstudies they wish to pursue because of the cost of
travelling to school, with the cooperation of local

postpartum care programmes.

municipalities, Tottori Prefecture is subsidising[High School Travel Expenses Subsidy Program]the travel expenses of students at high schools in・ Changing from the existing municipality-

Tottori Prefecture who use public transportation

managed programme to a joint municipality-

to travel to and from school.

prefecture-managed programme has been
received favourably as it has increased thenumber of assistance recipients and expanded
and improved assistance.
Issues and Responses[Fertility treatment costs]
・ Accurate knowledge about fertility needs to bedisseminated and taught, leading to early
infertility testing after marriage.
・ Information about the programme will bedisseminated through education provided in

Fertility treatment

collaboration

withinfertility

specialist

consultation centres and local municipalities’marriage notification acceptance windows.
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・ We will closely observe national movements[Postpartum care programmes]
・ In order for postpartum care programmes to(insurance coverage) and consider how the system

become established, Tottori Prefecture is working

can be further enhanced.

in collaboration with local municipalities, medical[Free postpartum care]institutions, and maternity homes to build a stable

・ In parallel with promoting the postpartum caresystem for providing expectant mothers in theprogramme, we will create places in each area

region with peace of mind and rest.

where expectant and nursing mothers who are not・Expectant mothers may have minor concerns thateligible for the postpartum care programme but

they are reluctant to consult medical institutions or

are experiencing anxiety can easily consult with alocal municipalities’ public health nurses about, as

midwife, exchange information with others, orwell as feeling alone or lonely, and their physicalotherwise take a mental break (respite).
・We will endeavour to enhance the role of maternity

and mental burden needs to be alleviated.

homes as places in the community that expectant[High school travel expenses assistance]and nursing mothers can depend on (regular・ To ensure a stable programme budget movingmaternity home).

forward, prefecture residents’ understanding of[High school travel expenses assistance]

the necessity of this programme needs to be

・By carrying out PR as part of our child care support

obtained.

policies that are a step ahead of the rest of Japan,
we will encourage families with children to moveto Tottori from outside the prefecture.
[Future developments aimed at further enhancing
childcare support]
・Aspiring to create a “Child Care Kingdom Tottori”
where people can say, “”I’m glad I was born inTottori”, or “I want to raise my children in Tottori”,
we will continue to promote policy measures
aimed at enhancing seamless child care support.
Reference URLs
[Free Postpartum Care] Prepartum and Postpartum
Care Questionnaire Survey Reporthttps://www.pref.tottori.lg.jp/secure/787368/sannz
ennsanngohoukokusyo.pdf

Assistance with school travel expenses, freeContact

postpartum care

Division in Charge: Child Care Kingdom Division, ChildCare & Human Resource Bureau, Tottori Prefecture

Future Developments (Anticipated Results, Outlook

Phone: ＋81-857-26-7148

for the Project, Issues, etc.)

E-mail: kosodate@pref.tottori.lg.jp[Expansion and Improvement of Fertility Treatment
Key Terms

Costs]
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