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

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Stagnant Stunting Rate Despite Rapid Economic Growth in Papua New Guinea: Factors Correlated with Malnutrition among Children under Five

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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Exploring Factors Driving the Performance of Rural Health Care in Papua New Guinea

2018-06-06, Cairns, Alan, Witter, Sophie, Hou, Xiaohui

Examining performance patterns of sub-national units, such as provinces and districts, within a health system is important to understand their drivers and what might be needed to improve outputs. Such literature is relatively rare in low and middle-income countries. It is particularly relevant for Papua New Guinea, which is underperforming in relation to its neighbours and targets for core health indicators and faces particular geographical challenges, with a dispersed and diverse population. In this analysis, we undertake simple correlation analysis between remoteness of populations, expenditure on frontline services and core outputs by provinces and regions, such as antenatal care, outpatient visits, outreach clinics, referrals of patients and facility supervision in 2012. In the context of the challenging geography of Papua New Guinea, these are expected to be important factors. Some expected patterns were found – for example, between remoteness and higher service costs, as well as between remoteness and higher outreach services. Outpatient visits, however, increased with remoteness, which was surprising. Our correlation analyses suggest a virtuous circle operating in some areas (even in the most geographically challenged) between outreach clinics, immunisation coverage, supervision, frontline spending and overall health system performance, which merits further investigation into the factors supporting these and how they can be reinforced elsewhere. Whilst expenditure did not correlate closely with provincial performance, it was evident that the provinces with higher performance across the selection of metrics typically were also the higher spenders on frontline services. There was some correlation of higher performance with density of public provision. More fine-grained assessment, including at the district level, will be needed to understand the low levels of outreach clinics, transfers and supervision, all of which are critical for quality health care in these kinds of contexts. The analysis illustrates what can be learned from combining routine data sources, as well as the limits and the need to complement such analysis with more detailed local qualitative investigations. It also reinforces the message that local leadership, supportive supervision and resources directed to frontline services can be effective in raising health system performance, even in challenging settings.

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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

2011-11, Friedman, Jed, Hou, Xiaohui, Hong, Seo Yeon

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.

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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.