The birth rate in mainland China declined from 12.95‰ in 2016 to 6.39‰ in 2023, posing significant challenges to social harmony and sustainable development. To evaluate the effectiveness and impact of family planning policy adjustments, this study collected birth rate and population data for mainland China (2007 - 2023) and eight provinces, including Shanghai and Beijing (provincial-level municipalities), Xinjiang, Heilongjiang, Hunan, Hebei, Hainan, and Guangdong. Using Joinpoint regression and autoregressive integrated moving average models, we analyzed birth rate trends, assessed the stimulatory effects of four family planning policy adjustments (2011 - 2021), and projected future birth rate trajectories for both mainland China and the selected provinces. The findings show that the partial two-child policies (2011, 2013) stabilized national birth rates and triggered short-term regional increases. The universal two-child policy (2016) caused a temporary surge, followed by a continued linear decline. The three-child policy (2021) failed to reverse this trend and had a negligible impact. Key drivers include a 19% decrease in the population of women of childbearing age and a 34% decline in childbearing willingness. Projections from birth rate models (2024 - 2030) demonstrate a continued national decline, with significant regional disparities in both demographic characteristics and policy responsiveness. To address these dual challenges, China must implement comprehensive reforms to its national family planning policies to support sustainable social development, alongside province-specific interventions tailored to local demographic conditions to maintain regional balance.
Funding
This research was supported by funding from the Shunyi District for Health Improvement and Research (Grant No. Wsjkfzkyzx-2023-q-05).
Conflict of interest
The authors declare that they have no competing interests.
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