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
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
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
Using Allocative Efficiency Analysis to Inform Health Benefits Package Design for Progressing towards Universal Health Coverage: Proof-of-Concept Studies in Countries Seeking Decision Support
(PLoS, 2021-11-29) Fraser-Hurt, Nicole ; Hou, Xiaohui ; Wilkinson, Thomas ; Duran, Denizhan ; Abou Jaoude, Gerard J. ; Skordis, Jolene ; Chukwuma, Adanna ; Lao Pena, Christine ; Tshivuila Matala, Opope O. ; Gorgens, Marelize ; Wilson, David P.Countries are increasingly defining health benefits packages (HBPs) as a way of progressing towards Universal Health Coverage (UHC). Resources for health are commonly constrained, so it is imperative to allocate funds as efficiently as possible. We conducted allocative efficiency analyses using the Health Interventions Prioritization tool (HIPtool) to estimate the cost and impact of potential HBPs in three countries. These analyses explore the usefulness of allocative efficiency analysis and HIPtool in particular, in contributing to priority setting discussions. -
Publication
Vulnerability Map for Response to the COVID-19 Epidemic: A Case Study on Indonesia
(Washington, DC: World Bank, 2022-02-01) Hou, Xiaohui ; Stewart, Benjamin P. ; Tariverdi, Mersedeh ; Pambudi, Eko Setyo ; Harimurti, Pandu ; Nagpal, Somil ; Jia, Wei ; Vicencio, Jasmine Marie ; Görgens, Marelize ; Garrett, Keith PatrickThe COVID-19 pandemic has emerged as a threat to global health security. This paper uses geospatial analyses to create a COVID Vulnerability Mapping Dashboard that examines and displays social vulnerability indices at the national and subnational levels in Indonesia. The dashboard answers three main questions: 1. Where are the vulnerable populations 2. What is the capacity of local health systems and 3. What is the local trend in COVID cases The dashboard prototype presented herein was developed and used to direct attention to geographic areas where risks are expected to be greatest. -
Publication
Understanding Health Workers' Job Preferences to Improve Rural Retention in Timor-Leste: Findings from a Discrete Choice Experiment
(PLoS, 2016-11-15) Smitz, Marc-Francois ; Witter, Sophie ; Lemiere, Christophe ; Eozenou, Patrick Hoang-Vu ; Lievens, Tomas ; Zaman, Rashid U. ; Engelhardt, Kay ; Hou, XiaohuiTimor-Leste built its health workforce up from extremely low levels after its war of independence, with the assistance of Cuban training, but faces challenges as the first cohorts of doctors will shortly be freed from their contracts with government. Retaining doctors, nurses and midwives in remote areas requires a good understanding of health worker preferences. The article reports on a discrete choice experiment (DCE) carried out amongst 441 health workers, including 173 doctors, 150 nurses and 118 midwives. Qualitative methods were conducted during the design phase. The attributes which emerged were wages, skills upgrading/specialisation, location, working conditions, transportation and housing.