Socio-economic and environmental factors influenced the United Nations healthcare sustainable agenda: evidence from a panel of selected Asian and African countries

  • Hummera Saleem
  • Wen Jiandong
  • Abdullah Mohammed Aldakhil
  • Abdelmohsen A. Nassani
  • Muhammad Moinuddin Qazi Abro
  • Khalid ZamanEmail author
  • Aqeel Khan
  • Zainudin Bin Hassan
  • Mohd Rustam Mohd Rameli
Research Article


The objective of the study is to evaluate socio-economic and environmental factors that influenced the United Nations healthcare sustainable agenda in a panel of 21 Asian and African countries. The results show that changes in price level (0.0062, p < 0.000), life risks of maternal death (4.579, p < 0.000), and under-5 mortality rate (0.374, p < 0.000) substantially increases out-of-pocket health expenditures, while CO2 emissions (5.681, p < 0.003), prevalence of undernourishment (15.184, p < 0.000), PM2.5 particulate emission (1557, p < 0.000), unemployment, and private health expenditures (30.729, p < 0000) are associated with high mortality rate across countries. Healthcare reforms affected by low healthcare spending, unsustainable environment, and ease of environmental regulations that ultimately increases mortality rate across countries. The Granger causality estimates confirmed the different causal mechanisms between socio-economic and environmental factors, which is directly linked with the country’s healthcare agenda, i.e., the causality running from (i) CO2 emissions to life risks of maternal death and under-5 mortality rate, (ii) from depth of food deficit to incidence of tuberculosis and unemployment, (iii) from PM2.5 emissions to infant mortality rate, (iv) from foreign direct investment (FDI) inflows to PM2.5 emissions, (v) from trade openness to greenhouse gas (GHG) emissions, and (vi) from mortality indicators to per capita income, while there is a feedback relationship between health expenditures and per capita income across countries. The variance decomposition analysis shows that (i) under-5 mortality rate will increase out-of-pocket health expenditures, (ii) unemployment rate will increase mortality indicators, and (iii) health expenditures will increase economic well-being in a panel of selected countries, for the next 10 years.


Environmental factors Socio-economic factors healthcare infrastructure carbon dioxide emissions GHG emissions Asian-African countries 


CO2 emissions

Caron dioxide emissions


Particulate emission 2.5 micrograms


Foreign direct investment

GHG emissions

Greenhouse gas emissions


Millennium development goals


Death rate


Depth of food deficit


Energy associated methane emissions


Health expenditures


Private health expenditures


Public health expenditures


Improved sanitation facility


Improved water source


Incidence of tuberculosis


Consumer price index


Lifetime risk of maternal death


Maternal mortality ratio


Female mortality ratio


Male mortality ratio


Infant mortality rate


Neonatal mortality rate


Under-5 mortality rate


Nitrous oxide emissions


Nurses and midwives


Out-of-pocket health expenditures




Population density


Prevalence of undernourishment


Trade openness


Unemployment rate


Measures of sampling adequacy

JEL Classification

C33 I15 J17 



The authors would like to extend their sincere appreciation to the Deanship of Scientific Research at King Saud University for its funding this Research group No. (RG-1436-037).


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Hummera Saleem
    • 1
  • Wen Jiandong
    • 1
  • Abdullah Mohammed Aldakhil
    • 2
  • Abdelmohsen A. Nassani
    • 2
  • Muhammad Moinuddin Qazi Abro
    • 2
  • Khalid Zaman
    • 3
    Email author
  • Aqeel Khan
    • 4
  • Zainudin Bin Hassan
    • 4
  • Mohd Rustam Mohd Rameli
    • 4
  1. 1.Department of EconomicsWuhan UniversityWuhanChina
  2. 2.Department of Management, College of Business AdministrationKing Saud UniversityRiyadhSaudi Arabia
  3. 3.Department of EconomicsUniversity of WahWah CanttPakistan
  4. 4.School of Education, Faculty of Social Sciences and HumanitiesUniversiti Teknologi MalaysiaSkudaiMalaysia

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