Person:
Hou, Xiaohui
Author Name Variants
Fields of Specialization
health economics; social safety nets; poverty
Degrees
ORCID
Departments
Health, Nutrition and Population, East Asia and Pacific Region, World Bank
Externally Hosted Work
Contact Information
Last updated
January 31, 2023
Biography
Hou, Xiaohui is a Senior Economist in the World Bank. Joined as a Young Professional, she has since worked in Human Development department and Poverty Reduction and Economic Management department across the East Europe and Central Asia region, the South Asia region, and most recently the East Asia and Pacific region. She also spent a number of years in the World Bank Institute, the capacity building arm of the World Bank, focusing on face to face training and network development. Her fields include health economics, social safety net, labor economics and impact evaluation. She has published a dozen of papers in both economics and medical peer reviewed journals. She also teaches as a visiting scholar. A Peking University graduate, she obtained her Ph.D. in the Health Services and Policy Analysis and a Master’s degree in Economics from the University of California, Berkeley, and a Master’s degree in Health Policy and Administration from the Washington State University.
Publication Search Results
1 - 10 of 16
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Exploring Factors Driving the Performance of Rural Health Care in Papua New Guinea
(World Bank, Washington, DC, 2018-06-06)Examining performance patterns of sub-national units, such as provinces and districts, within a health system is important to understand their drivers and what might be needed to improve outputs. Such literature is relatively rare in low and middle-income countries. It is particularly relevant for Papua New Guinea, which is underperforming in relation to its neighbours and targets for core health indicators and faces particular geographical challenges, with a dispersed and diverse population. In this analysis, we undertake simple correlation analysis between remoteness of populations, expenditure on frontline services and core outputs by provinces and regions, such as antenatal care, outpatient visits, outreach clinics, referrals of patients and facility supervision in 2012. In the context of the challenging geography of Papua New Guinea, these are expected to be important factors. Some expected patterns were found – for example, between remoteness and higher service costs, as well as between remoteness and higher outreach services. Outpatient visits, however, increased with remoteness, which was surprising. Our correlation analyses suggest a virtuous circle operating in some areas (even in the most geographically challenged) between outreach clinics, immunisation coverage, supervision, frontline spending and overall health system performance, which merits further investigation into the factors supporting these and how they can be reinforced elsewhere. Whilst expenditure did not correlate closely with provincial performance, it was evident that the provinces with higher performance across the selection of metrics typically were also the higher spenders on frontline services. There was some correlation of higher performance with density of public provision. More fine-grained assessment, including at the district level, will be needed to understand the low levels of outreach clinics, transfers and supervision, all of which are critical for quality health care in these kinds of contexts. The analysis illustrates what can be learned from combining routine data sources, as well as the limits and the need to complement such analysis with more detailed local qualitative investigations. It also reinforces the message that local leadership, supportive supervision and resources directed to frontline services can be effective in raising health system performance, even in challenging settings. -
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Challenges for Youth Employment in Pakistan : Are They Youth-Specific?
( 2011-01-01)This paper analyzes the patterns of and the challenges for youth employment in Pakistan and examines whether these challenges are youth-specific. Using the 2005/2006 Labor Force Survey, the analysis includes determinants of unemployment, determinants of working in the formal sector, rate of return on education, and determinants of working hours. The paper finds that many of the challenges to youth employment in Pakistan are not youth-specific. Policies should thus emphasize broader labor market reforms, even in the context of tackling youth employment issues. Still, some challenges are youth-specific, such as a higher youth unemployment rate and insufficient returns to better-educated youth. To address these challenges, more youth-specific interventions are needed. -
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Empowering Women : The Effect of Women’s Decision-Making Power on Reproductive Health Services Uptake - Evidence from Pakistan
( 2011-01-01)A large body of research has attempted to explore the links between women's autonomy and their uptake of reproductive health services in the South Asia region, but the evidence so far is inconclusive. This study uses the Pakistan Social and Living Standards Measurement Survey to examine the influence of household decision making on women's uptake of reproductive health services. The analysis finds that women's decision-making power has a significant positive correlation with reproductive health services uptake and that influential males' decision-making power has the opposite effect, after controlling for socio-economic indicators and supply-side conditions. The findings suggest that empowering women and increasing their ability to make decisions may increase their uptake of reproductive health services. They also suggest that policies directed toward improving women's utilization of maternity services must target men as well as women in Pakistan. -
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Targeted or Untargeted? The Initial Assessment of a Targeted Health Insurance Program for the Poor in Georgia
( 2011)The government of Georgia launched a Medical Insurance Program, a targeted health insurance program, in June 2006 to provide health insurance to the poor. Using administrative data from June 2006 to December 2006, this paper estimates the initial impact of the Medical Insurance Program relative to an untargeted health insurance program and assesses whether the benefits have reached the poorest among those eligible. The paper presents two main findings: first, the Medical Insurance Program has significantly increased beneficiaries' utilization of public health insurance for acute surgeries and inpatient services; and second, the benefits have reached the poorest among the beneficiaries. However, the findings are only applicable to the first six months of implementation and more analysis is required to understand the dynamics and long term impact of the reform. -
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The Heterogeneous Effects of a Food Price Crisis on Child School Enrollment and Labor : Evidence from Pakistan
(World Bank, Washington, DC, 2013-08)Using a panel survey, this paper investigates how the increase in food prices in Pakistan in 2008-2010 affected children's school enrollment and labor. The causal identification relies on geographical variations in the price of food (wheat). The results show that the negative impacts of food price increase on school enrollment differ by gender, economic status, and the presence of siblings. The negative effects on school do not directly correspond to the increase in child labor because the transition from being idle to labor activity or from school to being idle are significant, particularly among the poor girls. The results also show that children in households with access to agricultural land are not affected by higher food prices. The analyses reveal a more dynamic picture of the impact of food price increase on child status and contribute to broader policy discussion to mitigate the impact of crises on children's education. -
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A Snapshot of Health Equity in Papua New Guinea: An Analysis of the 2010 Household Income and Expenditure Survey
(World Bank, Washington, DC, 2015-06)This paper highlights challenges that the government of Papua New Guinea faces in delivering equitable health care. It analyses findings from the 2010 household survey, including sickness reporting, health service utilization and out of pocket expenditure, concluding that the poorest quintile is most vulnerable to illness, yet has the lowest utilization rates of healthcare facilities. The lack of healthcare workers and the distance to facilities are among the most dominant reasons cited for not utilizing healthcare facilities in the poorest quintile while out-of-pocket payments have minimal catastrophic impact, yet have still been found to be a barrier to utilization. The paper also sets out policy implications of these findings, including the need for the government to focus on, and prioritize, strengthening the health services delivery to achieve universal health coverage. -
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Stagnant Stunting Rate Despite Rapid Economic Growth in Papua New Guinea: Factors Correlated with Malnutrition among Children under Five
(World Bank, Washington, DC, 2015-06)Maternal and child undernutrition is a pervasive and detrimental condition in Papua New Guinea. Despite rapid economic growth during the past decade, the stunting rate for children under 5, one of the primary indicators for child undernutrition, was estimated at 46 percent in Papua New Guinea in 2010, stagnant from 44 percent in 2005. This paper analyzes the association between the demographic, socioeconomic, environmental, and health-related factors on nutritional status for children under age 5 years, using the 2009–10 Papua New Guinea Household Income and Expenditure Survey. Stunting and underweight rates sharply rise in the first 24 months. Even in the better-off quintiles, children suffer from suboptimal breastfeeding and complementary food in the first 24 months. In general, the regression results showed that household wealth and geographic location are crucial factors that contribute to children’s malnutrition. More importantly, food quality, measured by protein intake, has significant predicting power on child malnutrition. Broadly increasing socioeconomic status and improving the quantity and quality of caloric intake are general steps to improving health outcomes in Papua New Guinea. In addition, three key areas were identified as critical to alleviating the persistent and detrimental stunting rate in the country: (1) exclusive breastfeeding and complementary food; (2) interventions by health workers; and (3) nutrition education. -
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Financing the Frontline in Papua New Guinea: An Analytical Review of Provincial Administrations' Rural Health Expenditure 2006-2012
(World Bank, Washington, DC, 2015-09)Financing the Frontline updates the expenditure analysis carried out in Below the Glass Floor (2013) and tests whether the spending patterns emerging in 2009 and 2010 in Papua New Guinea have been sustained or improved in 2011 and 2012. The review also supports a better understanding of the issues that confront frontline service delivery — such as the ambiguity of roles and responsibilities in some rural health functions — and proposes next steps. Concurrently, the National Department of Health performance information on facilities (from the National Health Information System) has been reviewed. The integration of the expenditure analysis, the NHIS performance information and the findings from the Promoting Effective Public Expenditure facility surveys will provide a rich source of information to help sharpen understanding and shape solutions. -
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Health and Noncommunicable Diseases: Bending the Noncommunicable Diseases Cost Curve in the Pacific
(World Bank, Washington, DC, 2017-08-01)This is a background paper to the Pacific Possible report. Pacific Island countries suffer from a non-communicable diseases crises, with some of the world's highest rates of cardiovascular diseases and diabetes. This report estimates the long-term economic impact if the crisis continues unchecked. Implementation of the NCD roadmap is essential to stemming the crisis. -
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The Impact of the Food Price Crisis on Consumption and Caloric Availability in Pakistan : Evidence from Repeated Cross-sectional and Panel Data
(World Bank, Washington, DC, 2011-11)Welfare losses from the 2008 food price crisis in Pakistan are deepening the gap between poor and non poor populations and further increasing inequality between the provinces. To estimate welfare losses, the reduction in caloric availability at household level is measured. The analysis of calorie intake by source supports the notion that rural households were shielded from the worst effects of the crisis by their capacity to grow their own food. Compensating variation estimates suggest that the average household would need 38 percent of its total precrisis expenditure to maintain precrisis consumption levels. The impact of the food price crisis (measured as the percentage of total expenditure required to restore consumption to the precrisis level) peaked at the end of 2008 to twice as high as at the start of the year. Average household caloric availability fell by almost 8 percent between 2006 and first half of 2008. Urban households were relatively worse off than rural households during the crisis. Income gains from sales of agricultural commodities produced by rural households presumably offset the negative impact of the food crisis to some degree. The drawdown of assets over 2008-10 was another important coping mechanism, especially for households without access to land.