About 60 per cent of adults in China's west are confident they will have a promising future despite current heath and education woes, international researchers have revealed.

About 20 per cent cannot afford hospital treatment and more than one-third of families cannot afford tuition and college fees. However, about two-thirds of people living in rural areas and more than half of city residents, say they are better off than they were five years ago.

The findings were released last week by a Chinese-Norwegian team, which has been researching living conditions in western China for the past five years.

The survey, conducted by Norwegian research foundation FAFO and the National Research Centre for Science and Technology Development, interviewed 44,000 families in China's western regions except the Tibet Autonomous Region.

Jon Pedersen, head of research of FAFO, said despite major socio-economic differences, there was a confidence among the people surveyed.

"The differences in development within the western regions are very large, from modern cities like Chengdu with an important high-tech industry, to poor, traditional farming communities high in the mountains of Qinghai," he told China Daily.

"Compared with other developing areas in the world that I have been to, the feeling of optimism about the future that people show is the most striking."

Western China is home to about 28 per cent, or more than 400 million people, of the mainland population.

According to the research, 65 per cent of the rural residents and 54 per cent urbanites in western China said their living standards had improved over the past five years. For the coming five years, 66 per cent farmers and 60 urban residents believed they would be economically better off.

Wang Fenyu, a senior researcher of the Chinese research centre, yesterday said the results testified that the central and local government policies to narrow the wealth gap and promote social development were paying dividends.

Pederson also said key policies, such as the development of infrastructure and the recent lifting of the tax on farmers, appeared to be working.

However, the study found that despite a strong education push in rural areas, education costs were still unaffordable for poorer parents.

Although 94 per cent of children aged between 7 and 14 were at school, the attendance rate declined in high school, partly because one-third of families could not afford tuition and fees.

Many families fell into dire straits because of education costs: it took 74 per cent of a family's annual income to pay for one child's college education for a year, according to the research.

The research also found about 28 per cent of adults in western China could not read correspondence, and there were more illiterate women than men.

The report found Chinese living in western regions had access to various health facilities, including hospitals and community clinics.

But at least 20 per cent of the residents, both rural and urban, could not see a doctor primarily because they were unable to pay the medical fees.

Only 45 per cent of rural women gave birth at hospital, and 7 per cent of children aged 4 and above had never been given vaccination shots.

The findings have been submitted to governments in western China, and have become an important reference for policy-makers, according to Wang Fenyu.

"The most important, and most difficult, is to find ways in which people's achievements are not destroyed by ill luck: Disease, accidents, or natural disasters may easily wipe out a household assets," Pederson said.