Person:
Hou, Xiaohui

Health, Nutrition and Population, East Asia and Pacific Region, World Bank

Fields of Specialization

health economics; social safety nets; poverty

ORCID

0000-0002-8219-996X

Departments

Health, Nutrition and Population, East Asia and Pacific Region, World Bank

Last updated: June 4, 2024

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 Search Results

Now showing 1 - 10 of 13

Silver Opportunity Case Studies: Experiences with Building Integrated Services for Older Adults around Primary Health Care
(Washington, DC: World Bank, 2024-06-04) Hou, Xiaohui; Sharma, Jigyasa; Zhao, Feng; eds.
Health care systems must be prepared to address the expanding and complex needs of an aging population. Rather than a “silver challenge,” this situation should be seen as an opportunity to reevaluate and reorganize the health care delivery system holistically. "Silver Opportunity Case Studies" presents a comprehensive examination of care for older adults in diverse economic and geographic contexts through a collection of country and regional case studies. This collection of case studies complements the synthesis volume of global evidence—Silver Opportunity: Building Integrated Services for Older Adults around Primary Health Care—by offering practical insights for decision-making, sharing knowledge, and encouraging cross-learning. The book provides a deeper understanding of the complexities involved and highlights key issues and current practices at the country level. The overarching goal of the volume is to inform policy makers, health care professionals, and other stakeholders about effective practices for caring for older adults and to support the development of evidence-based policies that enhance their health and well-being.
Improving Allocative Efficiency in Zimbabwe’s Health Sector: Results from the Health Interventions Prioritization Tool
(World Bank, Washington, DC, 2021) Hou, Xiaohui; Gosce, Lara; Shamu, Shepherd; Sisimayi, Chenjerai N.; Lannes, Laurence; Wilkinson, Thomas David; Kerr, Cliff; Haghparast-Bidgoli, Hassan; Skordis, Jolene; Kerr, Thomas Michael
The country of Zimbabwe has seen some important improvements in key health outcomes since 2009. However, despite progress in some areas of the health sector, the country did not meet its Millennium Development Goals (MDGs) and current progress falls short of the Sustainable Development Goals (SDGs) milestones. As is often the case, the poor and rural populations in Zimbabwe bear a disproportionate burden of disease and health risks. The situation is compounded by national economic challenges and health sector spending inefficiencies that have resulted in households bearing an increasing share of health sector financing, mainly through out-of-pocket expenditures. Households provide approximately 25 percent of health sector financing in Zimbabwe. Again, the poor and rural populations are hardest hit by this economic reality. Zimbabwe was one of the few countries in which HIPtool was piloted at the proof of concept stage. HIPtool enables the mathematical prioritization of interventions based on existing data and a set of criteria. It provides a technical foundation to further develop an essential health benefits package. However, HIPtool, at this stage in development, still has strong limitations, which are outlined along with results in this report.
Turning Challenges into Opportunities: The Medium Term Health Expenditure Pressure Study in Timor-Leste
(World Bank, Washington, DC, 2016) Asante, Augustine; Hou, Xiaohui
Timor-Leste has achieved significant improvements in the health sector since becoming independent a little over a decade ago. Timor-Leste is undergoing an epidemiology transition as the non-communicable disease burden increases, while infectious disease prevalence remains high. The report aims to: (i) analyze trends in health sector public expenditures (budgets and realized expenditures); (ii) document trends in staffing and training, including their costs; (iii) understand the likely resource envelope available to the health sector over the next five years (from all sources); and (iv) provide options to adjust expenditures, to support key priorities, and improve the efficiency of existing expenditures to create space for key priorities. This report reviews the critical fiscal issues facing the health sector in the medium term, including the key areas demanding fiscal space, and the likely resource envelope from government and donors. The report analyzes past trends in health expenditures (by the government and donors), forecasts future resource availability, and examines implications for the Ministry of Health (MOH) to sustain delivery of quality health services. The report is organized as follows: chapter one gives introduction. Chapter two analyzes human resource development in health by discussing three scenarios for medium term health staff planning. Chapter three examines trends in government health spending by key expenditure areas and discusses the increasingly important role that government spending will play in the health sector. Chapter four analyzes the past trends in donor health financing in Timor-Leste. Chapter five concludes by reviewing four key areas (rising wage bill, pharmaceutical spending, overseas medical transfers, and declining donor spending) that are exerting pressure on health sector financing, and suggests policy recommendations based on the analysis detailed in this report.
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.
Determinants of Tobacco Consumption in Papua New Guinea: Challenges in Changing Behaviors
(World Bank, Washington, DC, 2015-06) Xu, Xiaochen; Hou, Xiaohui; Anderson, Ian
This 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.
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.
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, Xiaohui
In 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.
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, Xiaohui
Timor-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.
Reforming the Basic Benefits Package in Armenia: Modeling Insights from the Health Interventions Prioritization Tool
(World Bank, Washington, DC, 2021-03-26) Fraser, Nicole; Chukwuma, Adanna; Koshkakaryan, Marianna; Yengibaryan, Lusine; Hou, Xiaohui; Wilkinson, Tommy
Armenia is an upper-middle-income (UMI) country in the South Caucasus region. The Coronavirus (COVID-19) pandemic and a regional crisis have resulted in the real economy's contraction following rapid growth in the past five years. Improving access to high-quality health care is essential for responding to non-communicable diseases (NCDs) and preventing mortality from infectious diseases in Armenia. Armenia is faced with the challenge of achieving Universal Health Coverage (UHC) when funding for health services faces downward pressures due to a donor funding transition, the Coronavirus (COVID-19) pandemic, and regional conflict. This report is part of the World Bank’s technical support toward universal health coverage in Armenia, which includes advisory services and analytics aimed at supporting the government’s efforts to expand access to high-quality health care. The report draws on the Health Interventions prioritization tool to optimize allocations across essential health services in the basic benefits package and estimate the potential impact of these allocations on population health.
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.