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 44 Scopus

Publication Search Results

Now showing 1 - 10 of 17
  • Publication
    Health and Noncommunicable Diseases: Bending the Noncommunicable Diseases Cost Curve in the Pacific
    (World Bank, Washington, DC, 2017-08-01) Hou, Xiaohui; 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.
  • 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, 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.
  • 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, 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.
  • Publication
    Determinants of Tobacco Consumption in Papua New Guinea: Challenges in Changing Behaviors
    (World Bank, Washington, DC, 2015-06) 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.
  • 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, 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.
  • Publication
    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.
  • 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, 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.
  • Publication
    Learning from Economic Downturns : How to Better Assess, Track, and Mitigate the Impact on the Health Sector
    (Washington, DC: World Bank, 2013-10-03) Hou, Xiaohui; Yazbeck, Abdo S.; Smith, Owen
    Many countries around the world are moving toward universal health coverage, while navigating through periods of economic crisis. The impact of the economic downturn of 2008-09 on the health care sector has renewed efforts to make health systems more resilient during and after economic downturns. Health policy makers and development practitioners are grappling with how to better identify areas that make the health sector vulnerable to economic downturns, and how to track and mitigate the impact of economic downturns. To effectively manage the challenges resulting from economic uncertainty, the health sector must look at recent failures and successes as a learning opportunity for improvement, with the end result being greater health system resilience. This book, financed by the rapid social response program at the World Bank, responds to these challenges facing the health sector. It introduces a framework for assessing, tracking, and mitigating (A.T.M. framework) the impact of economic downturns on the health sector. This framework provides policy makers and practitioners in the health sector with a more systematic way to design and implement policies that can protect people, particularly the poor, from the negative effects of economic downturns. This book illustrates the benefit of implementing rapid surveys to track the impacts of crises in real time as economies shrink, and emphasizes the importance of building effective health information systems that can regularly monitor system changes. Analysis of several country case studies in developing countries sheds light on the importance of linking the health sector with the social protection sector, particularly social safety nets, using the common identification and targeting methods to reach the poor and the vulnerable. The more recent lessons from several European Union (EU) countries emphasize the importance of political economy in implementing policy reforms during economic downturns and again illustrate how the data can help facilitate more evidence-based policy making.
  • Publication
    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.
  • Publication
    Wealth : Crucial but Not Sufficient Evidence from Pakistan on Economic Growth, Child Labor, and Schooling
    (2009-02-01) Hou, Xiaohui
    The relationship between wealth and child labor has been widely examined. This paper uses three rounds of time-series, cross-sectional data to examine the relationship between wealth and child labor and schooling. The paper finds that wealth is crucial in determining a child's activities, but that this factor is far from being a sufficient condition to enroll a child in school. This is particularly the case for rural girls. Nonparametric analysis shows a universal increase in school enrollment for rural girls from 1998 to 2006. This increase is independent of wealth (measured by per capita expenditure). Multinomial logit regression further shows that wealth is insignificant in determining rural girls' activity decisions. Thus, interventions to increase school enrollment should incorporate broad-targeted, demand-side interventions as well as supply-side interventions.