Person:
Hou, Xiaohui
Health, Nutrition and Population, East Asia and Pacific Region, World Bank
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Fields of Specialization
health economics; social safety nets; poverty
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ORCID
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Health, Nutrition and Population, East Asia and Pacific Region, World Bank
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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.
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Publication
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) Friedman, Jed ; Hong, Seo Yeon ; Hou, XiaohuiWelfare 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. -
Publication
The Heterogeneous Effects of a Food Price Crisis on Child School Enrollment and Labor : Evidence from Pakistan
(World Bank, Washington, DC, 2013-08) Hou, Xiaohui ; Hong, Seo YeonUsing 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. -
Publication
Determinants of Tobacco Consumption in Papua New Guinea: Challenges in Changing Behaviors
(World Bank, Washington, DC, 2015-06) Hou, Xiaohui ; Xu, Xiaochen ; Anderson, IanThis paper analyzes smoking prevalence and smoking behaviors in Papua New Guinea. Using the 2009–10 Papua New Guinea Household Income and Expenditure Survey, the paper analyzes the determinants of tobacco use and tobacco choices in Papua New Guinea. The results show that adults (18 years and above) in the poorest quartile are more likely to smoke. Tobacco consumption imposes a large financial burden to poor households. Tobacco consumption accounts for about 23 percent of total household food expenditure for households in the poorest quartile, compared with 15 percent for the entire sample. However, most of these households consume non-processed tobacco. The study reveals the urgency to control tobacco consumption in Papua New Guinea and considers some practical challenges that the country may face. -
Publication
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) Hou, XiaohuiMaternal 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. -
Publication
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) Irava, Wayne ; Barker, Katie ; Somanathan, Aparnaa ; Hou, XiaohuiThis 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. -
Publication
A Snapshot of Health Equity in Papua New Guinea: An Analysis of the 2010 Household Income and Expenditure Survey
(World Bank, Washington, DC, 2015-05) Irava, Wayne ; Barker, Katie ; Somanathan, Aparnaa ; Hou, XiaohuiIn Papua New Guinea the poorest quintile is most vulnerable to illness, yet has the lowest utilization rates of healthcare facilities. When looking at age groups the elderly ( 55) are the most vulnerable to illness and the least likely to seek treatment. The lack of healthcare workers and the distance to facilities are among the most dominant reasons cited for not utilizing heath care in the poorest quintile. The perceived quality of services is a barrier to health care utilization across all quintiles. Out-of-pocket (OOP) payments have minimal catastrophic impact, yet have been found to still be a barrier to utilization - especially amongst the poorest quintile. The government should focus on and prioritize strengthening the health services delivery to achieve universal health coverage. -
Publication
The Heterogeneous Effects of a Food Price Crisis on Child School Enrolment and Labour: Evidence from Pakistan
(Taylor and Francis, 2015-11-17) Hou, Xiaohui ; Hong, Seo Yeon ; Scott, KinnonUsing a panel survey, this paper investigates how food price increases in Pakistan in 2008–2010 affect children’s school enrollment and labor. The causal identification relies on the geographical variations in food (wheat) price. 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 is significant, particularly among poor girls. The results also show that children in households with access to agricultural lands 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 child education. -
Publication
Financing the Frontline in Papua New Guinea: An Analytical Review of Provincial Administrations' Rural Health Expenditure 2006-2012
(World Bank, Washington, DC, 2015-09) Cairns, Alan ; Hou, XiaohuiFinancing 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. -
Publication
Empowering Women : The Effect of Women’s Decision-Making Power on Reproductive Health Services Uptake - Evidence from Pakistan
( 2011-01-01) Hou, Xiaohui ; Ma, NingA 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. -
Publication
Women’s Decision Making Power and Human Development : Evidence from Pakistan
( 2011-10-01) Hou, XiaohuiWhen deciding who should receive welfare benefits with the aim to increase household well-being, it is necessary to understand the effects of the distribution of power within the households at which the aid is directed. Two primary household models have been used to study intra-household bargaining and decision making: the unitary model and the collective model. The unitary model seems to fit Pakistan's context because the prevailing traditional culture positions the male head as the household decision maker. However, using a set of direct measures of decision-making power from the Pakistan Social and Living Standard Measurement Survey, this study finds that even in a country where men seem to have more power than women, the collective household bargaining model applies. This study also finds that, in Pakistan, when women have more decision-making power at home, households tend to spend more on women's preferred goods (such as clothing and education), family members eat more non-grain food items, and children, particularly girls, are more likely to be enrolled in school.