In China, upper-level healthcare (ULHC) and lower-level healthcare (LLHC) provide different public medical and health services. Only when these two levels of healthcare resources are distributed equally and synergistically can the public’s demands for healthcare be met fairly. Despite a number of previous studies having analysed the spatial distribution of healthcare and its determinants, few have evaluated the differences in spatial equity between ULHC and LLHC and investigated their institutional, geographical and socioeconomic influences and spillover effects. This study aims to bridge this gap by analysing panel data on the two levels of healthcare resources in 31 Chinese provinces covering the period 2003–2015 using Moran’s I models and dynamic spatial Durbin panel models (DSDMs). The results indicate that, over the study period, although both levels of healthcare resources improved considerably in all regions, spatial disparities were large. The spatio-temporal characteristics of ULHC and LLHC differed, although both levels were relatively low to the north-west of the Hu Huanyong Line. DSDM analysis revealed direct and indirect effects at both short-and long-term scales for both levels of healthcare resources. Meanwhile, the influencing factors had different impacts on the different levels of healthcare resources. In general, long-term effects were greater for ULHC and short-term effects were greater for LLHC. The spillover effects of ULHC were more significant than those of LLHC. More specifically, industrial structure, traffic accessibility, government expenditure and family healthcare expenditure were the main determinants of ULHC, while industrial structure, urbanisation, topography, traffic accessibility, government expenditure and family healthcare expenditure were the main determinants of LLHC. These findings have important implications for policymakers seeking to optimize the availability of the two levels of healthcare resources.

Gender mainstreaming is a key for achieving inclusive economic growth, poverty reduction and equitable development. A gender disaggregated analysis of changing livelihood activities is, therefore, crucial for devising gender-sensitive policies and programs. This paper presents a gender disaggregated analysis to assess trend and influencing factors of switching livelihood to higher returning activities at the intra-household level in three villages in rural areas of central Nepal. The result showed that both men and women have changed their livelihood activities from subsistence to cash-earning activities in the last decade. However, the livelihood activities of men have changed considerably compared to women. Men are primarily attracted to out-migration and non-farm wage-based jobs whereas women to market-oriented commercial farming and rural enterprises. Individual as well as location-specific characteristics influence behavior switching to higher returning activities irrespective of gender, while the ethnicity of a household influences only women. Building human and financial capital through education and training along with strengthening access to credit and increasing connectivity through rural road and market centers would be pivotal for encouraging rural men and women to change traditional subsistence activities to higher returning undertakings, leading to equitable livelihood improvement in rural Nepal.

Large-scale rural labor transfer is considered an important means of promoting urbanization and poverty alleviation; however, it has been difficult to fully reveal the complexity of mountain labor transfer using traditional theory. In this study, macrostatistics and microsurvey data were employed to conduct an empirical analysis of rural labor transfer in Xichang, highlighting the regional features of rural labor transfer in the southwest mountainous areas of China. The results show that the employment structure of rural labor is dominated by agriculture; however, its proportion is decreasing annually. The development of secondary and tertiary industries significantly contributes to the non-agricultural employment of rural laborers, who transfer mainly to the building, industry, and consumption fields—especially consumption, which has the greatest ability to absorb surplus rural labor. Migration of the population and farmers’ per capita net income promotes rural labor transfer, while the amount of rural labor, the urbanization rate in townships, agricultural development, and the topography have lagged effects on the process. This study argues that rural labor transfer in the mountains has regionality, multi-pattern, and gradient features; therefore, the promotion of rural labor transfer should consider local urbanization and poverty alleviation in such a manner that aligns with the local natural and socioeconomic conditions of the mountainous areas.