Knowledge of the statutory fertility provision and its associated factors among reproductive-aged women: a cross-sectional study conducted in Shandong Province, China.

OBJECTIVE: Knowledge of the statutory fertility provision is a critical but understudied determinant of effective policy implementation in the context of China's declining fertility rate. This study aimed to identify factors associated with such knowledge among reproductive-aged women aged 18-45 in Shandong Province, so as to provide empirical evidence for optimizing the fertility policy publicity system. METHODS: A cross-sectional survey was conducted using multistage stratified cluster sampling among reproductive-aged women in Shandong Province. Data were collected using a researcher-developed, self-administered questionnaire. The chi-square test and multivariate logistic regression were used to identify factors associated with knowledge of the statutory fertility provision. RESULTS: A total of 2,422 valid questionnaires were included. Only 43.31% of participants had adequate knowledge of the statutory fertility provision. Multivariate logistic regression identified four key factors independently associated with knowledge: residence, monthly total family expenditure, expected age at first birth, and preferred number of children (all p < 0.05). Rural residents had significantly lower knowledge than urban residents. Higher knowledge was observed among women with moderate monthly expenditure (4001-8,000 Yuan), those planning first birth at 28-34 years, and those expecting 3 or more children. CONCLUSION: Knowledge of the statutory fertility provision among reproductive-aged women in Shandong Province is low and associated with multiple sociodemographic and fertility-related factors. Targeted policy communication strategies that address rural-urban disparities and prioritize key groups are needed to improve policy awareness.