Addressing the Ultra-Low Fertility Crisis in Macao: A Comprehensive Analysis and Policy Framework

Macao faces a critical demographic challenge with the world’s lowest total fertility rate (TFR) of 0.582 in 2024. This threatens its long-term economic and social stability. This study investigates the multifaceted causes of Macao’s ultra-low fertility, relying on systematic data from 2001–2024, international comparisons, and a thorough policy assessment. Employing a mixed-methods approach, we identify key factors including prohibitive housing costs (9.1/10), significant education expenses (8.6/10), and persistent gender role conflicts. Findings reveal a distinct four-phase fertility decline, positioning Macao below South Korea (0.750). This demographic transition has led Macao to become an aged society, with its elderly population (14.5%) now exceeding the child population (12.5%). Despite these trends, current policies demonstrate limited effectiveness. The study proposes a comprehensive six-pillar policy framework emphasizing housing reform, childcare expansion, work-life balance, financial support, gender equality, and long-term monitoring. Implementation is structured across three phases (2025-2035) to stabilize the TFR, foster recovery to 1.0, and eventually approach the replacement level. This research provides the first systematic analysis of an extreme fertility case and offers evidence-based policy recommendations for small economies facing similar challenges.