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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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. 
Citations 10 Scopus

Publication Search Results

Now showing 1 - 10 of 15
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    The value of lost output and cost of illness of noncommunicable diseases in the Pacific
    (Elsevier, 2022-12-01) Hou, Xiaohui ; Anderson, Ian ; Burton-Mckenzie, Ethan-John
    The Pacific Island Countries face some of the highest rates of Noncommunicable Diseases (NCDs). This study estimates the economic costs of NCDs for each year from 2015 to 2040, focusing on eleven Pacific Island nations. Data and Methods: two methods were used to estimate the mortality and morbidity costs using a ‘value of lost output’ and ‘cost of illness’ approach respectively. Results: Five results stand out in terms of projected economic costs of NCD mortality and morbidity analyses in the Pacific: (i) the economic burden of NCDs in the Pacific is greater than expected for middle‐income countries; (ii) although cardiovascular disease is the biggest contributor to the mortality burden in the region, diabetes plays a far greater role in the Pacific countries compared to the global average; (iii) the economic burden of NCDs is increasing with time, especially as incomes rise; (iv) the biggest driver of lost output is the potential loss of labor due to early death from NCDs; and (v) the cost of illness due to diabetes is high across the Pacific countries, with highest among the Polynesian countries. NCDs alone can put enormous threat to the small Pacific economies. Targeted interventions to reduce disease prevalence, as outlined in the Pacific NCDs Roadmap, are vital to reduce the long-term costs associated with NCD mortality and morbidity.
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    An Evaluation of the Initial Impact of the Medical Assistance Program for the Poor in Georgia
    (World Bank, Washington, DC, 2008-04) Hou, Xiaohui ; Chao, Shiyan
    As part of the recent health reform effort, the government of Georgia launched a Medical Assistance Program in June 2006 to provide health insurance to its poor population. So far the program covers slightly over 50 percent of the poor and provides benefit coverage for outpatient and inpatient care. This paper estimates initial impact of the Medical Assistance Program and assesses whether the benefits have reached the poorest among those eligible, using utilization data from June 2006 to December 2006. Based on the analysis using a regression discontinuity design and a three-part model, the paper presents two main findings. First, the Medical Assistance Program has significantly increased utilization of acute surgeries/inpatient services by the poor. Second, the benefits have successfully reached the poorest among the poor. These two findings indicate that government efforts to improve the poor's access to and utilization of health services are yielding results. The paper emphasizes that the initial dramatic increase in surgeries must be interpreted with caution, given the possible misclassification or misreporting of acute surgeries in the data. The paper also stresses the need to continue monitoring implementation of the Medical Assistance Program and further improve program design, particularly the targeting mechanism, to achieve better efficiency, effectiveness and overall equity in access to health care services.
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    Challenges for Youth Employment in Pakistan : Are They Youth-Specific?
    ( 2011-01-01) Hou, Xiaohui
    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) Hou, Xiaohui ; Ma, Ning
    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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    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 Yeon
    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) Irava, Wayne ; Barker, Katie ; Somanathan, Aparnaa ; Hou, Xiaohui
    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) Hou, Xiaohui
    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) Cairns, Alan ; Hou, Xiaohui
    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) Hou, Xiaohui ; Anderson, Ian ; Burton-Mckenzie, Ethan-John
    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) Friedman, Jed ; Hong, Seo Yeon ; Hou, Xiaohui
    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.