Western Provinces Of China Research Articles

What Is the Mechanism of Resource Dependence and High-Quality Economic Development? An Empirical Test from China

For a long time, the resource curse had been widely concerned by researchers all over the world, especially in China. At present, China is in the transition stage from high-speed economic growth to high-quality development, and innovation and talents are important drivers. However, the existing research lacked an empirical test on resource curse and its transmission mechanism at the provincial level in China at this stage. In order to test the mechanism of transformation and upgrading of resource-based regions in the period of high-quality economic development, this study used the panel data of 30 provincial administrative regions of Chinese mainland (not including Tibet) from 2007 to 2017 to build a multi-step, multi-mediation model, and explored the direct and indirect impact mechanism of resource dependence on the high-quality economic development using the bootstrap method and generalized least square method. The key findings of this study were as follows: (1) The high-quality economic development level in the central and western provinces of China had been in a backward position compared with the eastern provinces. (2) There was a “resource curse” in the stage of high-quality economic development at the provincial level in China. (3) In terms of transmission mechanism, resource dependence had a negative impact on the high-quality economic development through the crowding-out effect of innovation investment and talents. Our conclusion provides a theoretical reference for other countries and regions to explore the relationship between resource dependence and high-quality economic development and may inform the economic development strategies by policymakers that wish to transform and upgrade the resource-based regional economy.

Continuing medical education and work commitment among rural healthcare workers: a cross-sectional study in 11 western provinces in China

ObjectivesContinuing medical education (CME) and work commitment are important for rural healthcare workers (RHWs) and rural medical work. The significant association between continuing education and work commitment has been reported...

Effect of an educational intervention on human papillomavirus (HPV) knowledge and attitudes towards HPV vaccines among healthcare workers (HCWs) in Western China

ABSTRACT Background Healthcare workers (HCWs) play a key role in the recommendation of HPV vaccination. Our study aimed to understand to what extent a structured health intervention could change the knowledge and attitudes toward HPV and its vaccines among HCWs in Western China. Methods This was a multi-center, questionnaire-based interventional study conducted across 12 cities of seven provinces in Western China, from November 2018 to July 2019. Participants were recruited from local health systems by e-invitation. Questionnaires were administered to participants before and after the intervention. Results A total of 1448 HCWs attended the educational lectures and 1354 participants completed both pre- and post-study questionnaires. In general, HCWs had satisfactory baseline knowledge regarding HPV and its vaccines compared with other populations, and a significantly higher knowledge level was observed after the intervention. However, some more specific knowledge on the vaccination procedures, other HPV-related diseases and whether HPV testing was required before vaccination was relatively poor. Following the educational intervention, the correct responses to the above questions increased (P < .001). However, it was still lower compared with answers to other questions. Change was also detected regarding HCWs’ willingness to recommend HPV vaccines to the appropriate population (P < .001). Conclusion Educational intervention on HPV and its vaccines is effective in improving HCWs’ knowledge levels and willingness to recommend HPV vaccines. Future educational interventions should focus more on knowledge regarding HPV-related diseases and HPV vaccination. Education campaigns targeting rural HCWs are urgently needed in the near future.

Place-based policies, state-led industrialisation, and regional development: Evidence from China's Great Western Development Programme

This study evaluates the effects of a prominent place-based policy in China—the Great Western Development Programme. In 2000, China's central government targeted inland provinces in Western China for considerable investment and preferential treatment to accelerate their industrialisation. Using a spatially discontinuous design, we find that the programme has succeeded in accelerating industrialisation, raising the annual GDP growth rate by 1.6 percentage points in the targeted regions. However, no such effects are observed on nonfarm employment or wages. Moreover, the GDP growth effects primarily result from massive physical investment rather than the growth of total factor productivity.

Designing energy policy based on dynamic change in energy and carbon dioxide emission performance of China’s iron and steel industry

China’s iron and steel industry is the key industry for the state to conserve energy and control CO2 emissions. In this paper, we divide China’s administrative regions into three groups using cluster analysis. Then we use energy and carbon dioxide performance index to evaluate the static efficiency in iron and steel industry. After, meta-frontier non-radial Malmquist directional distance function is constructed to measure the dynamic energy and carbon dioxide emission performance. The dynamic indicator is decomposed into efficiency change, best practice gap change, and technology gap change. According to this study, the static energy and carbon dioxide efficiency in China’s iron and steel industry still lags behind from 2000 to 2016. Group 1 (mainly eastern provinces of China) has the highest efficiency, followed by group 2, and group 3 (mainly western provinces of China) has the lowest efficiency. The technical efficiency and technical progress are driving factors improving energy and carbon dioxide performance, while the technology gap change does not help to improve the performance. Finally, we propose specific policy recommendations to promote the healthy development of the industry.

Analysis of Early Essential Newborn Care Capacities of Rural Health Facilities — Four Provinces in Western China, 2016

What is already known about this topic? The Early Essential Newborn Care (EENC) intervention package recommended by World Health Organization (WHO) is shown to prevent and treat the leading causes of newborn illness and death. China has begun widespread implementation of the EENC. What is added by this report? Among the 14 core interventions, including using antibiotics for mothers with premature rupture of membranes, immediate skin-to-skin contact of mother and baby, delayed umbilical cord clamping, kangaroo mother care for preterm newborn, and neonatal sepsis and pneumonia management, were not sufficiently implemented in health facilities in western China. What are the implications for public health practice? There are gaps between the implementation situation and WHO recommendations in terms of EENC capacities in western China. Targeted interventions developed accordingly can ensure quality child health care and decrease newborn mortality in China.

Impacts of the New International Land–Sea Trade Corridor on the Freight Transport Structure in China, Central Asia, the ASEAN countries and the EU

The New International Land–Sea Trade Corridor (ILSTC) is a trade and multimodal transport corridor jointly built by the western Chinese provinces and the ASEAN countries. The ILSTC treats Chongqing and the Beibu Gulf ports of mainland China, Hong Kong and Singapore as different transport hubs through which it attempts to link the western provinces of China with the ASEAN countries. International trade among the ASEAN countries, Central Asia and the EU can also be improved by the existing China Railway (CR) Express service from western Chinese cities. To analyze the impacts of the ILSTC on the freight market structures of West China, Central Asia, the ASEAN countries and the EU, first, the current freight transport route alternatives and those of the ILSTC were selected as the study objectives. Second, data on freight route alternatives were collected and analyzed. Third, the choice behavior in freight transport and the market share of the ILSTC were determined and calculated using a multinomial logit model. The impacts of the ILSTC on freight transport structures are discussed and related suggestions for the development of international logistic service providers are proposed.

Rural Resident Experience on National Basic Public Health Services: A Cross-Sectional Survey in 10 Western Provinces of China.

National basic public health services (BPHSs) are important for promoting the health of rural populations. A better understanding of rural BPHSs from the viewpoint of residents utilizing the services can help health-related departments and primary health care (PHC) centers further improve rural BPHSs. By conducting a large-scale cross-sectional survey in 10 western provinces of China, the study depicts rural resident experiences with rural BPHSs. Of the 9019 participants, 59.33% and 66.48% did not receive services related to health examinations or health education in the six months prior to the survey, respectively. A total of 56.90% were satisfied with the rural BPHSs, and the mean overall satisfaction score was 3.61 ± 0.908 (out of a maximum of 5). The most satisfying domain for rural residents with BPHSs was the attitude of PHC workers, whereas rural residents with chronic diseases were the least satisfied with the health management. Satisfaction with the attitude of PHC workers was identified as the strongest determinant of rural residents’ overall satisfaction with BPHSs. This study could enlighten rural BPHSs management in China.

Awareness of HIV/AIDS and its routes of transmission as well as access to health knowledge among rural residents in Western China: a cross-sectional study

BackgroundThe purpose of this study was to evaluate the coverage of HIV health education among rural residents in western China by ascertaining their awareness of HIV/AIDS and its transmission routes, and to investigate how these residents receive health information.MethodsA survey was conducted through stratified clustered sampling at 99 county hospitals in 11 provinces in western China. Information was collected on awareness of HIV/AIDS and its transmission routes, as well as residents’ access to health knowledge. Chi-square analysis was used to analyse the differences in HIV/AIDS awareness (knowing of the existence of HIV/AIDS, hereinafter referred to as “HIV awareness rate”) between different subgroups categorized by demographic status, regional factors, and different methods of access to health knowledge. To further analyse the effects of access to health knowledge on HIV awareness, a logistic regression model was established. The relationship between access to health knowledge and transmission routes was also examined using chi-square analysis.ResultsThe HIV awareness rate of the total 9274 participants was 80.9%. There were statistically significant differences between subgroups classified by age (χ2 = 482.118, p<0.001), education (χ2 = 853.465, p<0.001), occupation (χ2 = 340.553, p<0.001), income (χ2 = 186.448, p<0.001), cumulative HIV cases according to province (χ2 = 59.513, p<0.001), per capita annual net income of rural households according to province (χ2 = 64.676, p<0.001), proportion of minority population according to province (χ2 = 94.898, p<0.001), direct access to health knowledge (medical staff: χ2 = 419.775, p<0.001; mass media: χ2 = 740.238, p<0.001; family members: χ2 = 12.189, p<0.001; socializing: χ2 = 48.780, p<0.001; health education activities: χ2 = 154.400, p<0.001), and indirect access to health knowledge (having a non-communicable disease with medical instructions χ2 = 78.709, p<0.001; physical examinations: χ2 = 135.679, p<0.001). The logistic regression model showed that education and mass media had the strongest impacts on HIV awareness among all methods of access. Participants had the least awareness of HIV’s mother-to-child transmission route.ConclusionThe HIV awareness rate indicated that previous HIV health education covered 80% of the rural population in western China. Mass media should take greater responsibility in HIV health education for the general population, and special attention should be paid to the elderly, the most impoverished population, minority community as well as the mother-to-child transmission route.

The role of education in maternal depressive symptoms among different ethnic groups: A cross-sectional study in rural western China

Objective: To estimate the maternal depressive symptoms (MDS) rates in different ethnic groups, and to explore possible reasons especially the role of education for its ethnic differences.Methods: A community-based cross-sectional survey was conducted in 20 rural counties of 8 provinces in western China. The possible influencing factors of MDS were collected. The Edinburgh Postpartum Depression Scale (EPDS) was used to assess MDS. Univariate and multivariate logistic regression models were used to analyze the risk factors of MDS. Two multivariate logistic regression models that separately containing and not containing the factor of educational level were used to explore the role of education in the ethnic differences of MDS.Results: A total of 3,163 mothers were included in the analysis, and the MDS rate was 15.6%. In multivariate analysis, educational level of primary school and below (adjOR1: 1.47, 95%CI: 1.07–2.03), delivery at home (adjOR1: 1.66, 95%CI: 1.11–2.47) and diarrhea of youngest child in the past two weeks (adjOR1: 1.31, 95%CI: 1.03–1.67) remained as independent predictors of MDS after adjusting all the factors significant in univariate analysis. If educational level was not adjusted in above multivariate model, women from Yi ethnic group (adjOR2: 1.39, 95%CI: 1.03–1.89) would additionally become significant.Limitations: EPDS is a screening tool and some possible risk factors for MDS were not included.Conclusion: The ethnic differences in MDS were largely due to the ethnic differences in educational level. To reduce the high risk of MDS among Yi mothers, further popularizing nine-year compulsory education could be effective.

Patient Satisfaction with Rural Medical Services: A Cross-Sectional Survey in 11 Western Provinces in China.

Rural medical services play an important role in protecting and promoting the health of the rural population; however, patient satisfaction with rural medical services has been understudied in China. A better understanding of the actual situation and the determinants involved will provide evidence for health-related policy makers and hospital managers to further improve rural medical services. A total of 9811 patients (5208 outpatients and 4603 inpatients) were included in this study from a cross-sectional survey conducted in rural hospitals from 11 western provinces in China. Three in five patients (including outpatients and inpatients) were satisfied with rural medical services. The mean overall satisfaction scores were 3.61 ± 0.857 and 3.80 ± 0.829 (out of a maximum of 5) for rural outpatients and inpatients, respectively. The most satisfying domains for outpatients and inpatients were medical service attitude and illness explanation, and waiting time and medical expenses were the domains that outpatients and inpatients were least satisfied with. Satisfaction with medical technology (OR: 1.73; 95% CI: 1.57–1.92) and satisfaction with trust in physicians (OR: 2.05; 95% CI: 1.85–2.28) were identified as the strongest predictors of outpatients’ and inpatients’ overall satisfaction with rural medical services, respectively. This study might shed light on rural medical services management in China.

Does previous job mobility behaviour have an effect on current turnover intentions of rural nurses? A cross-sectional survey in western China

BackgroundNursing shortages are a serious problem in rural China. Little evidence has been found to determine the factors influencing turnover of rural nurses in China. Meanwhile, the effect of nurses' previous job mobility behaviours (ie, nurses who previously moved between different institutions) on their current turnover intentions is rarely identified. This study aimed to identify these factors and determine other factors related to the turnover of rural nurses in China. MethodsA cross-sectional survey was done in seven western provinces of China in 2013. 1163 rural nurses participated in the survey and 1158 were enrolled in this study after data cleaning. Turnover intention was set as a dependent variable; variables related to previous job mobility behaviour including whether they had a previous job mobility behaviour (ie, yes or no), the way of last job mobility behaviour (ie, moving from a same-level medical institution, from a low-level to a high-level medical institution, from a high-level to a low-level medical institution, or from a non-medical institution), and the time of last job mobility behaviour (ie, ≤3 years ago, 4–6 years ago, or ≥7 years ago) were set as the independent variables; and all other variables were set as confounders. We used a descriptive analysis, Pearson's χ2 test, one-way ANOVA, and binary logistic regression analysis for our data analyses. FindingsApproximately 326 (28·2%) of 1158 rural nurses disclosed turnover intentions. 525 (47·1%) had previous job mobility behaviours. The previous job mobility behaviours of rural nurses had a significant effect on their current turnover intentions (odds ratio [OR] 1·85, 95% CI 1·34–2·56); further analyses indicated that the specific way (moving from a same-level medical institution, OR 2·72, 1·59–4·66; moving from a high-level to a low-level medical institution, 1·82, 1·02–3·27; moving from a non-medical institution, 2·37, 1·09–5·17) and time (moving 4–6 years ago, 2·57, 1·59–4·17; moving ≥7 years ago, 2·01, 1·25–3·24) of last job mobility behaviour were significantly associated with nurses' turnover intentions. Other risk factors for turnover intention in rural nurses included a high-level professional title (eg, the title of chief [associate] nurse; OR 4·40, 1·43–13·54), low-level job satisfaction with effort–reward balance (0·77, 0·62–0·96), and social support from superiors (0·67, 0·55–0·83). InterpretationPrevious job mobility behaviours of rural nurses significantly increased their odds of current turnover intentions, especially for those rural nurses who moved between two same-level medical institutions within 4–6 years for the last time of job mobility behaviour. Hospital managers should pay more attention to these rural nurses to reduce their turnover. Reasonable job mobility channels related to career development for rural nurses should also be established. FundingChina Medical Board: Situational Analysis and Policy Evaluation of Development and Retention of Human Resources for Health in Rural Western China (10-029).

A Brief Analysis of Shannxi Cuisine’s English Translation - Taking Menu Translation as an example

Dissemination of Chinese culinary culture is important for Chinese culture to go global. Shannxi, a western province of China, features abundant cuisine which is representative of Shannxi local’s lifestyle. However, there are many spelling mistakes and other translation mistakes in some time-honoured Chinese restaurants’ English menu. Appropriate translation strategies, including domestication, foreignization and Pinyin, a phonetic transcription system for Chinese characters,should be adopted to explore practical and feasible translation of the culinary culture.

Delayed peak of human infections and ongoing reassortment of H7N9 avian influenza virus in the newly affected western Chinese provinces during Wave Five

ObjectivesEight additional provinces in western China reported human infections for the first time during the fifth wave of human H7N9 infections. The aim of this study was to analyze the epidemiological and virological characteristics of this outbreak. MethodsThe epidemiological data of H7N9 cases from the newly affected western Chinese provinces were collected and analyzed. Full-length genome sequences of H7N9 virus were downloaded from the GenBank and GISAID databases, and phylogenetic, genotyping, and genetic analyses were conducted. ResultsThe peak of human infections in the newly affected western Chinese provinces was delayed by 4 months compared to the eastern Chinese provinces, and both low pathogenic (LP) and highly pathogenic (HP) H7N9-infected cases were found. The LP- and HP-H7N9 virus belonged to 10 different genotypes (including four new genotypes), of which G11 and G3 were the dominant genotypes, respectively. Almost all of these viruses originated from eastern and southern China and were most probably imported from neighboring provinces. Genetic characteristics of the circulating viruses were similar to those of the viruses from previously affected provinces during Wave Five. ConclusionsA delayed peak of human infections was observed in the newly affected western Chinese provinces, and reassortment has been ongoing since the introduction of H7N9 viruses. This study highlights the importance of continued surveillance of the circulation and evolution of H7N9 virus in western China.

Are Medical Graduates' Job Choices for Rural Practice Consistent with their Initial Intentions? A Cross-Sectional Survey in Western China.

Global concerns persist regarding the shortage and misdistribution of health workers in rural and remote areas. Medical education is an important input channel of human resources for health. This study aimed to identify the association between medical graduates’ job choices for rural practice and their initial intentions when they began to look for a job in China. Data were extracted from a cross-sectional survey among medical students in ten western provinces in China in 2013. Only medical students who were in the last year of study (i.e., medical graduates) and had found a job were included in this study. Of the 482 participants, 61.04% (293) presented an initial intention of rural practice when they began to look for a job, and 68.88% (332) made a final job choice for rural practice. However, of the 332 graduates with a final job choice of rural practice, only 213 (64.55%) had an initial intention. A univariate association was identified in which medical graduates who were more likely to make final job choices for rural practice were those having initial intentions (OR: 1.59; 95% CI: 1.08–2.36); however, after adjusting for controlled variables, it became insignificant and was reduced to a 1.31-fold increase (95% CI: 0.82–2.07). The initial intentions of medical graduates are not assurance of ultimate job outcomes, and it cannot be deduced that all medical graduates who made a final job choice for rural practice had authentic desires for rural practice. Twenty years of age or below, low-income families, majoring in non-clinical medicine, and studying in a junior medical college or below were associated with medical graduates’ final job choices for rural practice. More studies are required on how to translate medical student’s intention of rural medical practice into reality and how to retain these graduates via a job choice in rural practice in the future.

Foreign Trade Structure, Opening Degree and Economic Growth in Western China

This paper presents an interactive study on the relationship between the foreign trade structure, opening degree and economic growth of the provinces in western China (except Tibet). It shows that the export of primary products and labor-intensive products has a positive impact on the external development of the western region, while the export of capital and technology-intensive products has a smaller inhibitory effect on it. At the same time, the system GMM model shows that the opening degree of the western region has a positive effect on economic growth. After including the foreign trade structure interaction item, this result has not changed, and on the basis of opening up to the outside world, the export of labor-intensive products and capital-intensive products plays a significant role in promoting economic development. Therefore, this paper holds that the western region should optimize its foreign trade structure, continue to promote the construction of foreign trade demonstration, and give priority to the development of local characteristic industries to promote economic growth.

Quantifying the teleconnections between local consumption and domestic land uses in China

Land teleconnections refer to the socioeconomic and environmental interactions related to land use among distant regions. China has been experiencing radical land use changes since its economic reform in 1978. The quantification of land teleconnections is critical for understanding land-related social and environmental problems. This study describes the land teleconnections in China at the provincial scale, using a multiregional input-output model and the latest domestic trade data in 2012. It is found that large amounts of land in the western provinces of China are consumed by the coastal provinces. More than 90% of land consumed by Beijing, Tianjin and Shanghai is from other provinces. Agricultural land mainly transfers in the west-to-east and north-to-south directions. The regions in Northeast and Northwest China have the largest amount of agricultural land outflow compared with the other regions. At the national level, 11.21% of cultivated land, 14.23% of aquatic land, 12.06% of forestland, 9.70% of grazing land and 13.04% of built-up land are exported through international trade. Despite the economic benefits accompanying interregional land flow, vulnerable regions with severe water shortages may face a even more challenging future if the current land teleconnections strengthen. By presenting the latest information with respect to the land teleconnections, our results can provide a basis to further assess the ecological degradation due to distant land utilization and allow the identification of the specific land consumers that should be responsible for the ecological degradation.

A study on the association between the infant anemia and the utilization of maternal and child health services in ethnic minorities gathering in poverty-stricken rural areas of two provinces in Western China

In this study, 1 065 infants and young children aged 24 months below in ethnic minorities gathering in poor rural areas in poor rural areas of Liangshan Yi Autonomous Prefecture of Sichuan Province and Gannan Tibetan Autonomous Prefecture of Gansu Province were investigated for their anemia status from October to November 2014, and the association between anemia and the utilization of maternal and child health services was analyzed. The prevalence of anemia in this area was 52.68%(561/1 065). After the adjustment of socio-demographic characteristics of mothers and infants, compared with infants aged 2-5 months, Han ethnic group, and infants whose mother was not anemic, the OR(95%CI) values of infant anemia for infants aged 6-12 months, 13-8 months, 19-24 months, ethnic minorities group, and infants whose mother was anemic were 11.65 (7.09-19.14), 9.91 (5.99-16.38), 5.87 (3.39-10.16), 1.55 (1.10-2.18) and 1.52 (1.14-2.04), respectively; Compared with infants whose child examination times not up to standard, and who were not only non-hospital delivered but also received inadequate number of inoculation, the OR (95%CI) values of infant anemia for infants whose child examination times up to standard, and who were not only hospital delivered but also received adequate number of inoculation were 0.60 (0.38-0.94) and 0.71 (0.52-0.98), respectively. The infants anemia is associated with the utilization of maternal and child health services.

Internal Coordinated Development of China’s Urbanization and Its Spatiotemporal Evolution

High urbanization quality, predominantly determined by the degree of internal coordinated development, is the most important factor in promoting urbanization development. Based on the panel data of 283 Chinese cities from 2007 to 2016, this paper analysed the internal coordination degree, spatial distribution and spatiotemporal evolution of urbanization using the methods of range standardization, entropy, and coupling and coordination models, as well as exploratory spatial data analysis. We found the following results: (1) The internal coordination degree of China’s urbanization was at a low level for a long time, but it presented a gradually increasing trend; (2) The internal coordinated development of urbanization exhibited an obvious spatial agglomeration. Specifically, it displayed a stepped pattern with a higher internal coordination degree in eastern China, a lower degree in western China, and a spatial distribution with multi-centre agglomeration and diffusion. (3) The spatial distribution of the internal coordinated development of urbanization was stable in most regions of China, only changing in a few. (4) The growth rate of the internal coordination degree of China’s urbanization presented the pattern of a dotted distribution, while the growth rate in western China was higher than in central and eastern China. The spatiotemporal evolution relates to the policies changes of China’s urbanization. In particular, the urbanization in China transfers its focus from population transfer to the development of quality from 2007 to 2016. To promote the sustainable and healthy development of China’s new urbanization, Beijing-Tianjin-Hebei Region, Yangtze River Delta and Pearl River Delta shall focus on accelerating the transformation of economic development mode; The provinces located around the above three regions shall strengthen the upgrading and promotion of basic public services. The northeast and central provinces shall speed up the innovation of systems and mechanisms and gradually release the potential of urbanization development by promoting the mobility of urban population, and the vast majority of provinces in Western China shall further improve the spatial development potential for urbanization.

Job satisfaction, work stress, and turnover intentions among rural health workers: a cross-sectional study in 11 western provinces of China

BackgroundHealth workforce turnover remains a global concern, particularly in rural and remote areas. Western rural areas are the least developed in China, where it faces the serious challenge on the rural health worker (RHW) management. This study aimed to investigate job satisfaction, work stress, and turnover intentions of RHWs, and to explore prominent factors associated with turnover intentions of RHWs in rural western China.MethodsFrom June to September 2013, based on a three-stage random sampling method, a cross-sectional survey was conducted among RHWs in 11 western provinces in China. A brief, structured questionnaire filled in by RHWs was used for data collection. A total of 5046 RHWs participated in the study. The response rate was approximately 93.1%. Exploratory factor analyses, Pearson’s chi-squared tests, one-way ANOVA, binary logistic regression analyses, and mediating effect tests were performed for data analyses.ResultsApproximately 29.1% of the 5046 RHWs indicated turnover intentions. Most of the RHWs disclosed low educational levels, income levels, and professional technical titles. The RHWs expressed slight job satisfaction (mean 3.20) and moderate work stress (mean 3.22). Age, income, medical institution, and job satisfaction (i.e., organizational management, reward, and occupation satisfaction) were significant predictors of the RHWs’ turnover intentions. The RHWs, who were younger (less than 41 years), receiving an income of $326.8–$490.1 per month, working in township hospitals, and having low job satisfaction, were more likely to have turnover intentions. Work stress had an indirect and positive effect on RHWs’ turnover intentions. Job satisfaction weakened the positive effect of work stress on turnover intentions of RHWs by playing a total mediating role. Reward satisfaction was the strongest mediator.ConclusionsThe turnover intentions of RHWs in western China are significantly associated with job satisfaction, work stress, age, income, and medical institution. Appropriate strategies should be implemented to improve RHWs’ job satisfaction and reduce their work stress. Meanwhile, providing more attractive wages and non-monetary support, improving working conditions, etc. could be effective to reduction in RHWs’ turnover intentions.