Education and inclusive growth in West Africa

Purpose – Many West African countries face the challenge of growth inclusiveness. The region is also facing challenges of equipping its teeming population with high-quality skills despite many reforms and initiatives introduced in the past. This study, thus, identifies education as a crucial contributory factor to growth inclusiveness in the region. It, therefore, examined the role ofeducation in growth inclusiveness in WestAfrica between 1990 and 2017. Design/methodology/approach – The study utilised different proxies to capture quantity and quality dimensionsofeducation.TheunitrootandARDL “ Bounds ” testswereemployedatapreliminarystage.Based onthe preliminary tests,the studyexploredautoregressive distributed lagsmodellingtechnique tocapturethe short-run and long-run dynamic effects. Findings – The empirical results reveal a positive impact of school enrolment measures in most of the countries in both short-run and long-run. Education quality measure exerts positive impact and significant in few countries under consideration. Practical implications – These countries should give adequate attention to quality when designing education policy to foster their inclusive growth. Originality/value – This study highlights the critical role of education in the inclusive growth pursuit. Educationquantityisimportanttogrowthinclusivenessbutthequalityofeducationismorefundamental.Thequalityofeducationpossesseddeterminetoalargeextent,whatindividualcancontributetotheproductiveactivitieswithintheeconomyandaccessibilitytobenefitsfromeconomicprosperity.

Introduction
The record of growth in developing countries specifically in the last 20 years has been impressive especially in countries from sub-Saharan Africa (SSA). This is evident in the delivery of consistent positive growth digits from the average annual growth of 1.6-4.5% over the last two decades (see WDI, 2016). This pattern can similarly be observed in West African countries as they have recorded an average annual growth of 4.9% in the last two decades. As a matter of fact, some of the countries that recorded impressive and consistent positive annual growth in the region include Nigeria, Ghana, Senegal and Burkina Faso. These countries have demonstrated remarkable performance in maintaining high growth rates relative to other developing economies.
One of the key objectives of these countries is sustenance of consistent growth over the years, though there was negative growth in some economies such as Nigeria, when there was a significant drop in the international oil price in 2015. This, for instance, resulted in a significant drop in the growth as well as a recession in a country such as Nigeria. This, further raises the question of whether these countries can continue to base their growth on commodity prices. In the recent years, attention has been shifted to inclusive growth since most developing countries especially West African countries, that demonstrate high economic growth trajectory, are still faced with enormous socio-economic problems. According to Ianchovichina and Gable (2012), inclusive growth guarantees sustainable and rapid decline in poverty and inequality through labour force contribution as well as benefiting from economic growth process. In addition, growth inclusiveness ensures income expansion of lower-income group at fast pace while no social groups are not neglected in the growth process (Warner, 2012). This narrative could not be found in many West African countries.
The essence of inclusive growth has been documented in the literature (see Oyinlola et al., 2020;Raheem et al., 2018;World Economic Forum, 2014;OECD, 2013;Arezki and Nabil, 2012). Thus, the challenge facing the developing region such as West Africa can be linked to the lack of inclusiveness of the economic growth trajectory. One key candidate that drives this growth inclusiveness is the accumulation of skills and knowledge through education. Many developed countries built their growth on their human capacity advancement particularly through the provision of quality education to their citizens. Thus, their growth created many opportunities that allowed people to contribute enormously to growth processes as well as increase economic prosperity accruing to the citizenry. On this basis, West African countries need to re-strategize by creating knowledge-based economies rather than commodity-based economies. This is necessary in order to ensure that a greater number of citizens contribute actively in growth process.
Further, as argued in the literature, knowledge accumulation has been identified as a key driver of growth because it involves building human capacity to raise the level of productivity (Kotaskova et al., 2018;Novak and Dahal, 2016;Jalil and Idrees, 2013). Undoubtedly, West African countries have been making some progress in some areas of human capital development. This is apparent in the success recorded in school enrolment. In recent time, the region recorded a high number of school enrolment (i.e. primary and secondary). This coincides with an episode of high growth rate in the region which give insight to the level of human capital investment in the region. Accessibility of a larger number of the population to education gives the opportunity to the citizens to participate in the growth process through their engagement in productive activities. By this, people are expected to have access to many opportunities thereby expanding the prosperity of the region. Despite the progress recorded in educational quantity (i.e. school enrolment), there is still serious issue with education quality which inclusive growth heavily relied on. This further reflects in the persistent socio-economic problems affecting the region. The challenge here lies in the insufficiency of the indicators to assess the progress of these countries in terms of education quality. For instance, the increase in school enrolment may be necessary but may not translate to acquiring the skills needed to contribute meaningfully to the growth process. Similarly, Hanushek and W€ oßmann (2007) argue that educational quality matters in the growth process rather than mere school enrolment. This implies that an assessment of the role of education in growth inclusiveness needs to go beyond quantity but also quality.
The tenuous pattern of economic prosperity in these countries specifically, has continued to raise questions on how this high growth trajectory appears not to have created opportunities for a greater number of the citizenry. Indisputably, these countries are still struggling in recording outstanding performance in multiple indices of measuring economic development. They are ranked amongst the lowest performers in some key indicators such as school completion rate, maternal mortality, teacher-pupil ratio, control of corruption, infant mortality adult and literacy rate amongst others. Despite the performance in economic growth, there is still a high level of unemployment amongst the youths, high poverty rate, high out-of-school children, high inequality amongst others in the region. According World Economic Forum report (2014), education, and skills and employment were identified as critical to building growth inclusiveness and development. Thus, there is more to do in West African countries in terms of equipping the teeming population with quality education for them to participate in the growth process significantly.
Existing studies on economic growth in West African countries (such as Adedeji and Oyinlola, 2019;Ayinde and Yinusa, 2016;Sacerdoti et al., 1998 amongst others) have focussed more on other determinants (financial development, human capital amongst others) while little attention has been given to nature of education (in terms of quality and quality) and inclusive growth. Thus, this study posits that West African economies should be more concerned about the inclusiveness of their growth through the quality of education. Relying on performance in school enrolment is not sufficient and this is evident in the high level of unemployment due to scarce opportunities. Despite the impressive number of studies in the area of growth in sub-Saharan Africa including West African countries in particular, the role of education in growth inclusiveness of West African countries have been given little attention in the literature. Therefore, this study seeks to explicate the influence of education on growth inclusiveness. In addition, the study considers different measures of education to capture both its quantity and quality dimensions. Thus, this study hypothesizes that growth is not sufficient to measure the progress in the economy but rather the inclusiveness of growth is more important. This inclusiveness can only be achieved when people have quality education to contribute meaningfully to productivity level. This study captures the quality of education through a proxy that measures the rate of return to education and average years of schooling (i.e. index of human capital) while quantity is captured through the traditional measure (i.e. school enrolment). Therefore, the study provides a detailed analysis and evaluation from the empirical approach, on the growth inclusiveness process in West Africa through education. Specifically, we seek to provide answers to the following research questions: does education promote growth inclusiveness in the West Africa? What nature of education enhances growth inclusiveness in the region? Does the nature of education that impact growth inclusiveness varies across countries in the region?
The study conducts a country-by-country analysis for eight countries in West Africa between 1990 and 2017. The autoregressive distributed lag (ARDL) modelling technique is deployed to capture the short-run and long-run impacts. The rest of the paper is structured as follows: The second section captures the synopsis of the related literature. The third section focusses on the methodology and model specification. The fourth section presents the results and discussion, while the last section deals with conclusion and some policy lessons.

Synopsis of related studies
In recent years, multilateral corporations, national governments and regional blocs have been intensifying effort towards achieving inclusive growth since high economic growth is not sufficient to addressing several socio-economic problems in the developing countries. This is premise on the high unemployment rate, huge income disparity, ever-increasing poverty rate amongst others, in the developing region. According to Raheem et al. (2018), inclusive growth is a growth that ensures all income, social and economic groups contribute to the expansion of productivity or growth process. Similarly, growth is inclusive when there is increase in social opportunity function which relies on average opportunities available to the citizenry and distribution of opportunities amongst different citizenry (Ali and Son, 2007). Therefore, the economic growth that solves the socio-economic problems can be regarded as inclusive growth. But, inclusive growth also relies significantly on sustainability and continuity (i.e. must be steady and stable over time). This idea of growth has been championed by Organization for Inclusive growth in West Africa Economic Cooperation and Development (OECD), United Nations Development Programme, World Bank amongst others. Several plausible determinants have been identified for inclusive growth and human capital is one of the key drivers of such growth.
Human capital is seen as one of the drivers of economic growth. Education and health are the components of human capital needed for economic growth. Several works in the literature have established the relationship between education and economic growth. These studies include Nowak and Dahal (2016), Gyimah-Brempong (2006), Kot askov a et al. (2018), Barro (2013), Jalil and Idrees (2013), Lin (2003), amongst others. Gyimah-Brempong et al. (2006) investigated the impact of higher education on economic growth in 34 African countries over the 1960-2000 period using dynamic panel data estimator. They reveal that there is a positive and statistically significant relationship between all levels of education and economic growth. Similarly, Jalil and Idrees (2013), found a positive effect of different levels of education on economic growth in Pakistan.
Some studies argued that not all the levels of education have a significant impact on economic growth. Tertiary education is construed to be more significant to economic growth. However, the role of primary and secondary education should not be undermined as they provide the foundation upon which tertiary education is built. In a study conducted by Nowak and Dahal (2016) on the contribution of education on economic growth in Nepal, using ordinary least square (OLS), a positive relationship was found between education and economic growth. They further established that tertiary education is most significant to growth while elementary education is less significant. The expertise and skill taught by tertiary education institutions are the reason why it contributed to growth than the primary and secondary school education. Individuals with primary education are still not considered to be sufficiently equip with the skills needed for higher productivity in the economy. One of the channels through which education contributes to growth is research and development (R&D). In the European countries, the significant source of growth is the R&D of higher educational institutions to technological capital (Pastor et al., 2018). A well-educated labour force increases the total factor productivity and contribute to factor accumulation (Babatunde and Adefabi, 2005). Barro (2013) argued that the average years of schooling attainment is positively related to the level of growth. Delgado et al. (2013) showed the importance of education for economic growth. Wolfenden (2015) provides a detail overview of education challenges in Africa where quality at secondary and tertiary levels are greatly affected. This, in turn, retards growth process as a larger share of the population does not possess adequate knowledge and skills.
Recently, focus has been shifted towards inclusive growth due to the fact that some countries with high growth rate are still characterised by high poverty level and unemployment rate. More importantly, the relevance of inclusive growth has been demonstrated on a global, regional and national levels (Raheem et al., 2018).  Oyinlola and Adedeji (2019) show that human capital positively influences inclusive growth in SSA region. In addition, education expenditure plays significant role in the growth inclusiveness in SSA region (Raheem et al., 2018). Employing dataset for 38 developing countries, structural transformation was found to be growth-enhancing for Asian countries while it is growth-reducing for Africa (Lin, 2012). In measuring the impact of education using educational factors in this study, attention is given to the difference between quantity and quality measures of education. Eventually, what matter is how education is able to impact economic growth and this relies on the quality of education received by the population.

Model specification
Quality education creates an avenue for an individual to participate in the growth process as well as benefitting from economic prosperity. Interestingly, the West Africa region has recorded progress in the total primary and secondary school enrolment rates in recent time. In addition, the region has also benefitted from a high and stable growth rate in the last two decades except for the recent burst in the oil market in late 2014. Despite recording high and stable growth coupled with improvement in school enrolment rate, there is a high level of unemployment, poverty and inequality. This has been aptly captured by analysts as "joblessness growth". Theoretically, education is expected to equip individuals with skills to engage in the production process. The quality of education thus determines the extent to which individuals can contribute to productivity and thereby share in economic prosperity. This study relied on the augmented neoclassical model proposed by Barro (2013) and Mankiw et al. (1992). Thus, we examine the direct effect of education on inclusive growth. In addition, we investigated if the choice of education measure used for analysis (quality and quantity) matter for growth inclusiveness. Given this, we specify the baseline inclusive growth equation as follows From Eqn 1, Y represents the log of GDP per person employed which serves as a proxy for inclusive growth. There is no consensus on the measurement or definition of inclusive growth in the literature. However, the justification for our measure is due to the fact it captures the income per worker. In other words, the measure focusses on people who engaged in the production process. It also captures the average opportunities available to the population and how these opportunities are shared amongst the population (Ali and Son, 2007). This measure amply captures growth and its sustainability as it encompasses unemployment level, income inequality and poverty level in a country (See Raheem et al., 2018 and. Thus, the GDP per person employed is appropriate in the context of our study as the proportion of the population that benefits from economic prosperity or opportunity is captured. In a standard growth model, labour and capital are critical in the production process, therefore both variables are included in our model. LABF is measured by labour force participation rate as a percentage of total population (ages 15-64 years) and CAP is the capital stock as a percentage of GDP. E t is the log of education indicators measured in terms of quantity (proxy by primary and secondary school enrolments -PSE and SSE, respectively), and quality (proxy by the index of human capital -IHC). These indicators provide robust information about seeking knowledge and quality of knowledge (Hanushek and W€ oßmann, 2007;Barro and Lee, 2013;Beck and Hall, 2013). It is important that individuals seek for knowledge which will influence productivity partially. However, the quality of knowledge is very critical for growth inclusiveness. The choice of proxy for quality is hinged on its computation which requires average years of schooling and an assumed rate of return to education (see Psacharopoulos, 1994;Barro and Lee, 2013;and Cohen and Leker, 2014). X t captures the control variables in the model. Theoretically, there are other key control variables that are preconditions for growth to be inclusive. These include foreign direct investment as a percentage of GDP (FDI) [1], inflation rate (INF) [2] and government consumption as a percentage of GDP (GOVT) [3]. The following variables are sourced from World Development Indicators (2018): GDP per person employed (constant 2011 PPP $), foreign direct investment, net inflows (% of GDP), labour force participation rate, total (% of total population ages 15-64), primary school enrolment (as percentage of gross), Secondary school enrolment (as percentage of gross), inflation, GDP deflator (annual %) and government final consumption expenditure (as percentage of GDP) while Capita stock (US million dollars) and Index of Human Capital are sourced from Penn World Table Version 9.

Estimation techniques
The use of ARDL is hinged on the pattern of integration from the unit root test as well as the outcome of the cointegration test. Thus, the study utilised the augmented Dickey-Fuller (ADF) and Philip Perron unit root tests and ARDL "Bounds" cointegration test. The preliminary tests are preconditions for the ARDL approach.
Following Pesaran et al. (2001), Eqn (1) can be expressed in the UECM form of the ARDL model as follows: α 1 ; α 2 ; α 3 ; α 4 ; and α 5 are short-run parameters while λ 1 ; λ 2 ; λ 3 ; λ 4 and λ 5 are long-run parameters. The ARDL framework allows "Bounds test" to expeditiously determine the cointegrating relation in small sample cases (Tang, 2003). This approach is suitable and flexible to any regressor order of integration, either I(0) or I(1) or mutually cointegrated while the dependent variable is expected to be I(1). It also allows for a large number of choices such as decisions with respect to the number of endogenous and explanatory variables. The approach permits a different number of optimal lags combination for different variables as well as capturing short-run and long-run coefficients independently.
As earlier mentioned, the study employed the Pesaran et al. (2001) ARDL model for the eight countries instead of the panel approach to avoid the problem of obscuring countries' specificities. In addition, it allows for easy analytical comparison amongst the countries in terms of their performance. This modelling technique is adopted due to its advantages. First, the model reveals that after suitable augmentation of the order of the ADRL model, the OLS estimators of the short-run parameters are ffiffiffiffi T p -consistent with the asymptotically singular covariance matrix. Second, the estimators of the long-run coefficients of the ARDL are very consistent. Third, valid inferences on the long-run parameters can be determined by employing the standard normal asymptotic theory. Fourth, Monte Carlo experiments provide strong evidence in support of efficiency of the approach in the time series econometric modelling.

Empirical result and discussion
The summary of descriptive statistics of all the series in the estimated models for the eight countries is presented in Table 1 below. The eight countries represent the sample drawn from the West African region based on data availability. The statistic of GDP per person employed shows that Nigeria and Senegal have relatively high average values compared to the other countries. In addition, Nigeria and Ghana have the highest volatility of GDP per person employed while Niger has the lowest. This shows a wide dispersion in the distribution pattern of GDP per person in Nigeria and Ghana. The observed pattern is not different from other African countries. For instance, the growth inclusiveness is worrisome in SSA countries as the region recorded low amongst the regions in world (Oyinlola Adedeji, 2020;Oyinlola and Adedeji, 2019;Raheem et al., 2018 amongst others). This implies that African countries need huge investment in key areas such as education to foster inclusive growth in the region.

Inclusive growth in West Africa
On capital stock, the statistical summary reveals that Nigeria and Ghana also have the highest average values amongst the eight countries. On the other hand, Gambia recorded the lowest value. In terms of fluctuation, Nigeria has the highest due to large dispersion as indicated by the huge difference between minimum and maximum values. On the other hand, Gambia has the lowest dispersion.
Focussing on the average value of labour force participation rate, Niger and Togo recorded the highest relative to other countries. However, Burkina Faso has the lowest standard deviation which indicates a small gap in terms of participation of potential workers in the labour market. In terms of primary school enrolment, Togo recorded the highest mean value compared to other countries. However, the average value of primary school enrolment is significantly low in Burkina Faso. In terms of standard deviation, Benin is largely unstable while Nigeria is the most stable. More so, Ghana has the highest mean value of secondary school enrolment while Burkina Faso is adjudged to record the lowest value. On the index of human capital development, Ghana has the largest while Burkina Faso recorded the lowest. In terms of standard deviation, Niger recorded the lowest value while Nigeria is the most volatile. In addition, the mean value of inflation rate is very high in Ghana relative to other countries and Niger has the least volatile. Burkina Faso has the highest average value of government final consumption. In summary, the information in Table 1 provides an insight into the pattern of growth inclusiveness and its drivers across the sample eight of West African economies.
To examine the stationarity of the series, the study uses two unit root tests, namely; ADF and Philip Perron (PP) unit root tests [4]. The two tests complement each other to establish the stationarity of the series. All the series are stationary either at level, I(0) or first difference, I(1). Given one of the preconditions for the utilization of ARDL, the unit root tests contain both level and first difference series and importantly the dependent variable is also stationary at first difference. Thus, this justifies the utilization of ARDL approach to examine the short-run and long-run impacts of education in terms of quantity and quality, on inclusive growth in West Africa. Also, the result of the bounds test in Tables 2-4 show that there is long-run relationship amongst the variables in all the models across the countries.
For detailed analysis, the results are in two folds. Education is measured in terms of quantity and quality. Different proxies are utilised to capture the role of education.          presents the empirical results from ARDL estimation with primary school enrolment across the eight countries in the region. The results reveal that the initial level of inclusive growth plays a significant role in determining the current level of inclusiveness. The coefficients of lagged dependent variables are positive and statistically significant in five countries (Benin, Gambia, Niger, Nigeria and Togo) while negative but only statistically significant in two countries, namely, Ghana and Burkina Faso. Togo recorded the highest impact as indicated by the large coefficient. Thus, the extent to which people benefit from economic prosperity depends on production expansion and participation in the production process in the previous year. The short-run coefficients of capital stock are largely negative (Benin, Burkina Faso, Ghana, Niger, Nigeria and Togo). However, the short-run coefficient of capital stock is positive and statistically significant. This implies that capital stock exerts a negative impact on inclusive growth in most of the countries in the region. The plausible reason may be attributed to the paucity of capital stock necessary to expand productivity which supposed to create opportunities for the teeming population in these countries. Further, the short-run coefficient of labour is negative across the countries except in Gambia, Niger and Senegal. This suggests that labour serves as a drag on the growth inclusiveness in most of these countries. Exceptionally, labour exerts a positive impact on inclusive growth in Gambia and Senegal. This may be linked to the participation of a large proportion of the labour force in these countries. Also, the short-run coefficient of inflation is positive in all the models across the countries except in Senegal. This implies that inflation does not exert significant influence on the growth inclusiveness in all these countries. On government spending, the results are mixed across the countries. The coefficients are negative for four countries (Benin, Burkina Faso, Nigeria and Senegal) while positive for the other four countries (Gambia, Ghana, Niger and Togo) but statistically significant in seven models except for Burkina Faso. The government spending can promote inclusive growth as indicated by positive influence in the four countries. In all, the coefficients are significantly small across the countries. Also, the results of FDI are mixed across the countries. The shortrun coefficient of FDI is very small except for Senegal. Four countries recorded positive impacts while the other four recorded negative impacts. Economically, these results provide insight into the nature of foreign investment inflows which appear not to create many opportunities for the people to participate in the growth process. This finding is similar to the robust studies by Iwasaki and Suganuma (2015) and Oyinlola and Adedeji (2020).
Focussing on educational quantity, primary school enrolment, the estimated short-run elasticities are positive across the countries except for Niger. In terms of statistical significance, they are only significant in four countries. Economically, the elasticities are very small across the countries. For instance, a 100% increase in primary school enrolment leads 0.2%, 0.5% and 0.9% in inclusive growth for Benin, Gambia and Senegal, respectively. Overall, the results imply that primary school enrolment exerts low influence on growth inclusiveness in all these countries. It further suggests that acquiring primary education may not suffice for people to participate in lucrative production process. Given world dynamics in development, enroling in primary school may serve as a precondition for building human capacity, but relying on this alone may not sufficiently equip the teeming population with required skills and knowledge to drive the economy on a sustainable growth path.
The next discussions focus on the long-run impact of primary school enrolment on inclusive growth across the countries. Starting with capital stock, its estimated coefficients changed significantly in terms of signs and level of significance for some of the countries. For the Gambia, its estimated coefficient changes to negative while the coefficient for Niger changes to positive. The estimated coefficient for Nigeria remains positive and statistically significant. This suggests that countries such as Nigeria and Niger experienced improvement in the inclusive growth through capital accumulation. In the growth literature, capital stock is expected to exert a positive impact on the long run growth. Thus, the capital stock has the potential to expand the production process in the long run for many people to be absorbed thereby making growth inclusive. In addition, the paucity of capital in countries such as Benin, Burkina Faso and Ghana, dampened growth inclusiveness.
Further, the long-run coefficients of labour are positive for five countries but only statistically significant in four countries. This tends to imply that labour spurs growth inclusiveness in the long run in some of these countries. This may suggest that the bourgeoning labour force has the tendency for promoting growth inclusiveness in the longrun if there is improvement in human capacity development across these countries. On inflation, the estimated long-run coefficients are not significantly different from the pattern observed in the short-run. In addition, the coefficients remain inconsequential. On government spending, the coefficients are significantly small with slight changes in the signs and level of significance. The long-run impact of foreign direct investment is not significantly different from its short-run impact.
The long-run impact of primary school enrolment on the inclusive growth across the countries is largely dominated by the positive signs. Though, its magnitudes remain very small in the long run. Thus, the fact remains that primary school enrolment may not be enough to drive robust growth inclusiveness. Despite the increase in primary school enrolment in these countries, the unemployment level remains at an alarming rate. This further suggests that growth inclusiveness may be dampened when a large proportion of the population possess only primary education qualification. In reality, many people with this education qualification do the menial job which may significantly hinder growth inclusiveness. R&D, invention, innovation and discoveries require high-quality skills and knowledge which primary education is not designed to provide.
The subsequent discussion focuses on the influence of secondary school enrolment on inclusive growth in the region as presented in Table 3. Focusing on the short-run estimates, there is a significant difference in terms of magnitudes, direction and level of significance, in the impact of the lagged dependent variable in this case. The coefficients of the lagged dependent variable are positive and statistically significant only in three countries (Ghana, Nigeria and Togo) while negative but only statistically significant in four countries (Burkina Faso, Gambia, Niger and Senegal). Ghana recorded the highest positive impact as indicated by a large coefficient while Niger recorded the highest negative impact across the models. Thus, for countries that recorded positive impact, this suggests that the extent to which people benefit from economic prosperity by participating in the production process in the previous year plays a significant role in determining growth inclusiveness in these countries.
On the other hand, in the countries that recorded a negative impact, the previous year's inclusive growth dampened the current level of inclusive growth. Further, there is a change in capital stock with respect to signs and level of significance in five countries when compared with the result in Table 2. The results remain mixed when secondary school enrolment was introduced. On labour, the results are largely negative and statistically significant for all countries except for Benin. This is indicative of the drag effect of labour on inclusive growth. In addition, there is a slight deviation of results on inflation and government spending from earlier results in Table 4. On foreign direct investment, the results show predominantly positive impacts but the magnitudes remain trivial.
Further, the second part of the discussion focuses on the role of secondary school enrolment in the growth inclusiveness process across countries in the region. The results show largely positive impacts of the secondary school enrolment on inclusive growth. Undoubtedly, secondary education is very important to growth inclusiveness in the region. Improvement in this level of education provides individuals with requisite skills to actively participate in the growth process. However, despite the positive impact, the magnitudes remain very low. For instance, a 100% increase in the secondary school enrolment leads to 0.2, 0.9 and 0.4% in inclusive growth for Benin, Ghana and Nigeria, respectively. Focusing on the long-run results, the traditional determinants yield results similar to those reported in Table 2. Although, there are slight changes in the magnitude and direction of the coefficients. For instance, the direction of capital stock changes for Gambia, Ghana and Togo. However, labour is largely negative and statistically significant when compared to the results in Table 2. Inflation is still dominated by positive coefficients across the countries and a similar pattern is observed in government expenditure. However, foreign direct investment is largely negative with more than half of the models statistically insignificant. The results show that secondary school enrolment is largely positive but only statistically significant in three models. This is an indication that secondary school education has potential to amplify the inclusive growth in these countries. These findings further support the argument of Nowak and Dahal (2016) that higher education enhances growth process faster than primary education.
The last part of the discussion focuses on the results when the education quality is introduced in terms of the index of human capital (computed from the average years of school and rate of return on education). Shifting attention to Table 4, the short-run results show that the lagged dependent variable is largely positive and statistically significant in all the models. The short-run coefficients of capital stock are largely positive compared to when education quantity was introduced. In the presence of quality education, capital plays a more significant role in driving the growth inclusiveness of most of the countries. Judging by the volume of capital stock, Gambia and Togo have the least amongst the countries. The low capital stock in these countries may be the major reason why it appears to be dampening inclusive growth. The narrative on labour does not significantly change as it is dominated by the negative signs. A plausible reason may be attributed to the predominance of underemployment and low skilled labour in most of these countries.
Expectedly, inflation is largely dominated by negative signs across the countries contrary to the finding under the earlier two measures of education quantity. Thus, inflation always exerts a negative impact on inclusive growth in these countries. Also, a similar pattern is observed for government spending. Foreign direct investment continues to drive non-inclusiveness of growth as its benefit accrues to a small portion of the population in the region. Focusing on the education quality as measured by the index of human capital, the results mostly reveal a positive influence of education quality on inclusive growth across the board. Quality education goes a long way in providing the individual with high-skills to drive R&D, innovation, discoveries and invention which are critical to inclusive growth. In addition, productive labour (with quality education) benefits from economic prosperity arising from the attendant growth. As productivity continues to expand, the gains from growth that accrue to an individual may depend to a larger extent, on the quality of skills acquired through education.
The long-run results of the traditional determinants slightly deviate from what we observed in Tables 2 and 3. The capital stock continues to exert a positive impact on inclusive growth in most of the countries while labour is largely negative across the countries. In addition, inflation is largely negative and statistically significant. Government spending is dominated by positive impact across the countries while foreign direct investment has both positive and negative impacts across the countries. Strikingly, education quality exerts a negative impact on the inclusiveness of growth in most of the countries except Benin, Senegal and Togo. We can interpret this to suggest that inclusive growth was not broadly enhanced by the education quality. The region is dominated by unskilled labour which may be a plausible reason for this outcome. In addition, the region is characterised by high out-ofschool children which has the implication for the growth inclusiveness since they are likely to be constrained by lack of skills to participate in the growth process in the long run. One can therefore conclude, by and large, that models with education quality perform better than the models with education quantity. Thus, education quality matters more for growth inclusiveness in the West Africa region. The post-estimation tests as presented in the tables show that the models are free from the problem of heteroscedasticity, serial autocorrelation, non-normality and non-linearity. Thus, the inferences drawn from the results are valid. Interestingly, this finding projects the low-quality education that characterised most countries in Africa (Wolfenden, 2015). This complicates the zeal of moving towards growth inclusiveness amongst the countries in the West African region.

Conclusion and policy suggestions
Using the ARDL modelling approach with annual time series data from 1990 to 2017, the study examined the impact of education (quantity and quality) on growth inclusiveness in eight countries in West Africa. The findings from the estimated models showed that the initial level of growth inclusiveness played a significant role in the determination of inclusive growth across the countries. The findings in the short run further showed that education quantity (primary school enrolment) exerted a positive impact on inclusive growth to a large extent. However, this impact was significantly small across countries. A similar impact is observed in the long run. The short-run results also indicated that education quality (secondary school enrolment) positively influenced inclusive growth in most of the countries in the region but with inconsequential magnitudes. In the long-run, a positive impact was also observed in more than half of the countries. For countries such as Ghana, Niger and Nigeria, education quantity dampened their growth inclusiveness. In addition, the short-run results revealed that education quality played a significant role in enhancing inclusive growth. However, this pattern is not totally sustained in the long-run as only three countries (Benin, Senegal and Togo) recorded positive impacts. Overall, the narrative is pointing to the fact that education quality is very important in spurring growth inclusiveness in the region. The inability of these West African countries to address educational issues may hinder the achievement of inclusive growth. This will further exacerbate the socio-economic problems such as unemployment, poverty, inequality amongst others. Drawing from the foregoing findings, the policymakers can truly foster growth inclusiveness within these countries as well as in the entire region by focussing on the following: (1) Designing education policy that will offer opportunities for easy access to the education by teeming population: there is need for these countries to make education free and mandatory by law at least at primary and secondary levels since the level of poverty is alarming. Despite that, most countries have initiate this at primary, there is need for enforcement and extension to other levels of education due to low income of most households in the region; (2) Quality teachers: there is a need for effective policy that will ensure regular and high quality training of educators as well as raising the standard of the profession. The potential to improve teachers' status at all levels of education to foster professional development practice is very important for these countries. This is essential for quality workforce that are needed for growth inclusiveness; (3) Upgrading school infrastructure to promote the quality of education should be a focal point for all governments that aim to deliver quality education to their citizenry and thereby serving as a catalyst for achieving inclusive growth; (4) Institutional structures central to the educational system needs to be overhauled to create conducive environment for learning and skills acquisition. The study is limited to West African countries. Thus, there is a need for future studies to explore this assertion in other African sub-regions. Notes 1. Alfaro et al. (2001) and Iwasaki and Suganuma (2015) 2. Khan and Senhadji (2000) 3. Arpaia and Turrini (2008) 4. Due to space constraint, the results are available on request.


extfieldsofstudy:
Political Science
Medicine

text:
Investing in the health of girls and women: a best buy for sustainable development

Human rights, theory, evidence, and common sense all suggest that greater investment in women’s health could be among the “best buys” for broader economic development and societal wellbeing, say Michelle Remme and colleagues

I nvestments in health are known to generate large social and economic benefits, in addition to saving lives and improving quality of life. 1 Yet given the 2030 global development agenda and its broad set of priorities, resources need to be targeted to interventions with the greatest impacts. The disproportionate impact on economic development of investments in women's education and economic participation is well known, but it is less well understood that programmes that improve women's health could have substantial and disproportionately higher economic and social returns, compared with other uses of social resources. 2 3 Meeting women's health needs and eliminating gender inequality are moral imperatives and fundamental human rights, and investment in women's health should therefore not require justification. However, the case is also compelling beyond the immediate health benefits. 4 5 Although women live longer than men, they have specific unmet health needs and higher morbidity. 6 In addition, women's biological and social roles make them central to intergenerational transfers and demographic and development effects. Moreover, women not only provide most of the informal care in homes and communities, they also represent 70% of the global health workforce, making them central to overall population health. 7 By considering only the direct health benefits of investments in women's health, we risk undervaluing the broader societal benefits and underinvesting in programmes to improve it.
We summarise the latest evidence on the impact of investing in women's and girls' health for the health, wealth, cohesiveness, and wellbeing of society in low, middle, and high income countries. We include evidence on sources of benefit embedded in a sustainable development framework 8 that considers the standalone and interconnected goals of gender equality, 9 human development, economic development, universal health coverage, political stability, and environmental sustainability.

Gender equality and women's empowerment
Women's access to healthcare and their ability to achieve good health are measures of gender equality and the realisation of women's human rights. This entails social norms that value women and girls' health; availability of quality healthcare options; and autonomy and informed choice for women and girls, free of coercion, discrimination, and violence.
Yet, in certain settings-for example, in India and Ethiopia-healthcare seeking and immunisation coverage are lower for girls, irrespective of socioeconomic factors, owing to son preference. 10 11 Moreover, women receive less evidence based clinical care than men, because the male body remains the reference in medicine and biomedical research, with significantly fewer women in clinical trials and fewer females in animal studies. 12 This gender bias limits the realisation of women's right to health and is evidenced by more side effects from treatment, fewer accurate diagnoses, and less treatment that is evidence based or adherent to guidelines. [13][14][15] For example, women in the United States and the United Kingdom are 25% and 50% more likely than men to be misdiagnosed for a stroke or heart attack, respectively. 16 Investing in women's health can improve both health outcomes and gender equality (box 1). The literature has tended to investigate the enabling role of women's empowerment for health service uptake and health outcomes. 17 Evidence suggests a strong association between women's use of family planning and their empowerment and agency, although the direction of effect is unclear. Yet, evidence also suggests that rights based, gender responsive health interventions and health systems can promote gender equity and women's rights. 18 For example, overcoming bias in medical research and clinical practice can increase the efficiency and equity of healthcare. This has been found in the US, where cardiovascular mortality among women has declined dramatically in the past decade, partly as a result of a greater focus on women's specific unmet needs and better adherence to treatment guidelines. 19 While many women experience mistreatment and abuse during facility based childbirth (including physical abuse; non-consented, non-confidential, or undignified care; discrimination; abandonment; and detention), respectful maternity care policies could reduce these violations in women's rights and improve quality of care, and service uptake. 20 Ensuring that women are healthier also requires approaches to reduce sexual and physical violence, which one in three women experience in their lifetime. 21 Evidence suggests that effective

KEY MESSAGES
• Investing in women's health could redress violations in women's rights and gender inequities, as well as generating disproportionately large health, economic, social, and environmental gains • Healthy women and girls tend to be more productive in both paid and unpaid work, have higher returns on educational investments, and contribute to positive intergenerational and community spillover effects and favourable demographics • Better women's health can be a result of progress towards universal health coverage and a contributing factor • Health systems often fail women because of fundamental biases in medicine and in the design of healthcare delivery and financing models • Investments in women's health can and should be used for more gender transformative and multisectoral approaches to maximise benefits beyond health doi: 10.1136/bmj.m1175 | BMJ 2020;369:m1175 | the bmj Box 1: Gender equality and equity • Gender equality means "the absence of discrimination on the basis of a person's sex in opportunities, allocation of resources or benefits, and access to services." 9 • Gender equity means "fairness and justice in the distribution of benefits, power, resources, and responsibilities between women and men. The concept recognises that women and men have different needs, power, and access to resources and that these differences should be identified and addressed in a manner that rectifies the imbalance between the sexes" (World Health Organization, 2002). 9 • Gender equality in opportunities and rights is therefore used when referring to it as a goal or end outcome, while gender equity is used when referring to the fair distribution of, and access to, healthcare inputs as a means of achieving the goal.
investments to prevent violence against women combine interventions that tackle women's health needs, support their economic empowerment, and challenge inequitable gender norms and power dynamics in society. 21 Such transformative approaches involving women and men have reduced the incidence of intimate partner violence by up to 50% and transformed gender norms within one to two years of intervention in a range of settings (including South Africa, Rwanda, Uganda, Tajikistan, Nepal, and Afghanistan). 22

Human and economic development
The ethical arguments and justifications for investing in the overall and reproductive health of women and girls are magnified by theory and evidence highlighting the value of health as a form of human capital that promotes economic wellbeing at the individual, familial, and societal levels. 23 Human capital promotes income growth and poverty alleviation through five main pathways: labour; education; capital accumulation; intergenerational, familial, and community spillovers; and favourable demographics. While most of these pathways apply to men and boys as well, we focus on how healthier women and girls affect economic growth and development and where there is a differential impact.

Labour
Healthy women tend to be more productive in the paid workforce and in their unpaid work, which includes contributions to fam-ily economic activities and a disproportionate share of child rearing, care for elderly or sick family members, and domestic work. 24 Globally, 76% of the 16.4 billion hours a day of unpaid care work is done by women. 25 Although not equally valued in standard economic metrics, both paid and unpaid work are clearly vital to household and societal welfare. 26 Healthy women also tend to miss fewer workdays owing to illness and be more productive when they work (provided the total hours worked do not exceed healthy levels). For example, multi-micronutrient supplementation among female tea pickers in India increased their productivity by 12%. 27 In the US, modelling suggests that reduced maternal mortality between 1920 and 1970 resulted in a 52% increase in labour force participation among women of reproductive age. 27 Of course, these effects of health on economic wellbeing are mediated by legal, institutional, and cultural factors that influence women's economic freedom, access to and control over property, employment, pay, capital, and household decisions. 28

Education
The health of women and girls in utero, infancy, childhood, and adolescence is reflected in their records of school attendance, progression through the education system, cognitive function, and their experience of long term physical and mental impairments associated with illness and injury. 29 Studies from Pakistan and Guatemala found that improved nutritional status among girls significantly increased their schooling (with less or no effect for boys). 27 The improved health of women and girls thus increases the returns on educational investment and is linked to their lifetime earnings, mainly via stronger representation in the paid workforce, greater economic empowerment, increased productivity, and greater longevity. 27 Intergenerational, familial, and community spillover effects Healthy women also promote economic wellbeing and progress by strengthening the environment-materially, emotionally, and socially-in which children are raised, in their nuclear and extended families and communities. Studies show that maternal health at birth, in childhood, and during pregnancy directly influences the health of children at birth, during their childhood, and into adulthood, with better maternal health reducing stunting and improving cognitive development and later productivity. 27 For example, studies from China and Nigeria found that fetal exposure to acute maternal malnutrition had negative impacts on risks of hypertension, literacy, and income in adulthood. 27 In Romania, children born after the abortion ban in 1967 had worse e d u c a t i o n a l a n d l a b o u r m a r ke t achievements. 27 In addition to affecting the health of her children, a mother's health is linked to her spouse's status in the labour market and earnings. 30 Moreover, the larger the share of household income generated by women, the larger the share of spending on nutrition and the smaller that spent on tobacco and alcohol. 31

Favourable demographics
Higher rates of infant and child survival more than offset reductions in fertility, allowing families and countries to escape from the heavy burden of youth dependency and enjoy the prospect of a demographic dividend. 32 For example, economic modelling suggests that Kenya, Nigeria, and Senegal could increase national income per person by 31-65% if their unmet need for family planning was met. 27 In Bangladesh, a drop in fertility rates was associated with increased earnings and assets for women. 27 Indeed, in settings with low economic growth and high fertility, improved health in women tends to accelerate fertility decline and concomitant economic gains. Improved male health, however, often results in higher fertility and therefore delayed demographic transition and economic take-off to sustained growth. 28 33 34 Environmental sustainability Better reproductive health could have important implications for the environment through reduced population growth and mitigation of natural resource degradation. [35][36][37] Indeed, countries responding to the effects of climate change have emphasised how rapid population growth is exacerbating the impact of climate change on their communities, pointing to the need to prioritise access to voluntary family planning. 38 While the literature on how climate change affects women's and girls' health is growing, less empirical evidence is available on the impact of women's access to, and uptake of, family planning services on climate change and adaptation mechanisms. 4 37 Interestingly, several studies identify opportunities to tackle health, family planning, and environment in an integrated manner to maximise their combined effect. 37 39 Universal health coverage and financial protection Universal health coverage means that everyone has access to essential health services that are of sufficient quality to be effective and which do not result in financial hardship for the individual or their household. 40 41 As countries progress towards universal health coverage, prioritising health services that predominantly affect women, including essential sexual and reproductive health services, will be key to achieving financial protection for the most vulnerable. [42][43][44][45][46] Studies show that maternal complications, emergency obstetric care, maternal mortality, and female cancers often result in catastrophic health spending in low and middle income countries, especially among poorer households. 47 48 There is also greater income related inequity in access to women's health services, compared with access to child health services. 42 46 49 Moreover, the need for out-of-pocket payments has been found to constrain women's use of healthcare services, more than that of men, given women's limited access to and control over household financial resources. 43 While spending on sexual and reproductive health services in low and middle income countries is particularly regressive, with the poorest households spending up to 10 times more of their income than wealthier households, 50 similar trends are found for the growing burden of non-communicable diseases, where vulnerable households spend between 5% and 50% of their monthly income covering the costs of chronic illnesses. 51 Although out-of-pocket spending is the most inequitable form of health financing, it does imply some access to health services, whereas women are more likely to forgo healthcare altogether for financial reasons or to access poorer quality healthcare. 52 Older women are less likely to have been formally employed and built up a safety net or pension but also live longer than men, exposing them to a higher risk of catastrophic health expenditures. 24 While we know more about the long term social, health, and economic consequences of maternal mortality for surviving infants, limited evidence is available on the social and economic burden of cancers in women and other deaths not related to child bearing. 47 Because more than 35% of health expenditure is paid out of pocket as user fees, and 100 million people are pushed into poverty each year after catastrophic health expenditures, 53 removing user fees and ensuring equitable healthcare financing-a key tenet of universal health coverage -is one mechanism for reducing this burden. Another is reducing women's need for healthcare by improving their health and wellbeing across their life course. Investing in women's health services and promotion could lead to a cycle that improves women's health outcomes and in turn reduces the economic burden of utilising health services. For example, access to sexual and reproductive health services, better mental health, and fewer chronic conditions increase women's employment and thereby their ability to contribute to tax and income based universal health coverage schemes. 54 Better women's health can be both a result of progress towards universal health coverage and a contributing factor, given that 165 million female healthcare providers form the backbone of health systems worldwide, delivering health services to five billion people and generating $3tn (£2.3tn; €2.7tn) in global health. 4 Even more women provide informal health and social care in households and the community. 55 The health of healthcare professionals and caregivers is decisive for access to quality health services by those who need them. In addition, ensuring that women can perform their duties free from violence and harassment in the workplace is critical to uphold their rights, as well as sustaining universal health coverage, which increasingly relies on frontline workers. Nurses, for example, are three times more likely to experience violence compared with other professional groups and thus are more likely to leave their jobs. 55

Political participation and stability
Healthy, educated, income generating, and empowered women are likely to assume more prominent and active roles in a community and to show less tolerance for gender inequality, lack of transparency, and lack of responsive political leadership. 2 While societies in which women are more politically active would conceivably be more stable politically, evidence for this is limited. Women's health issues play a key part in voter preferences, and associations have been found between women's health status (reduced mortality) and political participation, but it is primarily thought that better political participation leads to investments and improvements in women's health, rather than vice versa. 4 56 One modelling study found that US health aid (partly focused on women's health) had positive effects on state stability in sub-Saharan Africa. 57

Conclusions
Investing in women's health could redress violations in women's rights and gender inequities, as well as generating disproportionately large health, economic, social, and environmental gains. Given the ambitious 2030 sustainable development goal agenda and its $3.9tn annual price tag, identifying and prioritising "accelerators" that have multiple impacts across development targets is vital to achieve these goals. 58 Women's health programmes could be particularly critical entry points for integrated programming across sectors and development objectives, such as combining sexual and reproductive health services with interventions that challenge gender inequitable norms or support climate change mitigation. Indeed, investments in women's health should be used for more gender transformative and multisectoral approaches to maximise benefits beyond health.
Nonetheless, several key gaps exist in the evidence base. Firstly, considerably more literature examines how non-health factors and other development outcomes influence women's health than the bi-directionality of this relation and how improvements in women's health affect broader sustainable development, including universal health coverage, political participation, and environmental sustainability. Moreover, few studies have considered the impact of women's health beyond reproductive health and across the life course. 4 59 The evidence around universal health coverage provides a limited understanding of the differential gendered effects of different financing mechanisms or differences in out-of-pocket expenditures, catastrophic expenditures, and economic household burden from a woman's or man's ill health. 43 With the expected development gains from investments in women's health, elements of healthcare systems need to be re-engineered to respond better to the needs of women. Despite calls for patient centred healthcare, health systems often fail women because of fundamental biases in medicine and in the design of healthcare delivery and financing models. For example, women are three times more likely to die from a serious heart attack owing to unequal treatment. 15 Furthermore, health financing schemes based on formal employment and civil service were established in Europe in the 19th century to keep men healthy for battle and work in rapidly industrialising economies, yet they are still actively promoted across the world despite large informal work sectors being dominated by women. 43 Additionally, the most vulnerable women typically receive healthcare from the most under-resourced, undertrained, and undervalued health workers in the health system (community health workers, traditional birth attendants, and relatives). 4 Moreover, while many countries have developed primary healthcare systems around maternal and child health, we need to recognise that women's health is more than maternal and reproductive health 4 and that its impact on development extends beyond their reproductive role. For example, as primary caregivers and healthcare providers, women are in a key position to alter non-communicable disease risk factors at home and are central in responding to non-communicable diseases across the world, especially in resource limited settings where health systems cannot absorb and respond to the growing needs of chronic conditions.
The global landscape and political climate are areas of disinvestment in women's health, and women's sexual and reproductive health and rights in particular. 60 Health for all at all ages is a fundamental human right and the ambition of the sustainable development goals for health. 61 Recent evidence and thinking on the value to society of good health justify greater investment in health overall, in addition to increasing the amount spent on women and girls. 1 33 In the context of constrained healthcare resources and limited development budgets, we need to prioritise health interventions that maximise health gains, increase health equity, and optimise other development goals. Human rights, theory, evidence, and common sense all suggest that greater investment in women's health could be among the "best buys" for broader economic development and societal wellbeing.
We thank Professor TK Sundari Ravindran and peer reviewers for their comments on earlier drafts.


extfieldsofstudy: Medicine Business

s2fieldsofstudy:
Economics
Agricultural And Food Sciences

text:
Evaluating the holistic costs and benefits of corn production systems in Minnesota, US

Global agriculture aims to minimize its impacts on environment and human health while maintaining its productivity. This requires a comprehensive understanding of its benefits and costs to ecosystems and society. Here, we apply a new evaluation framework developed by the Economics of Ecosystems and Biodiversity for Agriculture and Food (TEEBAgriFood) to assess key benefits and costs on the production side of genetically modified (GM) and organic corn systems in Minnesota, USA. The market value of GM corn is $4.5 billion, and only $31.8 million for organic corn using production data and market prices of 2017. GM corn generates revenue of $1488 per hectare (at $121 per MT), which is significantly lower than the organic corn at $2793 per hectare (at $294 per MT). Using a novel three-stage wellbeing valuation, analysis of the associations between corn production intensity and subjective measures of general health and wellbeing indicates that the total non-financial health cost associated with GM corn is $427.50 per hectare or $1.3 billion annually. We also find that the total annual environmental cost associated with GM corn production is $179 per hectare or $557.65 million within Minnesota. The use of the evaluation framework can help to improve decision making at farm and policy level to develop sustainable agriculture in order to minimize environmental and health related costs to society and economy.

Farming systems
The dominant corn production systems in Minnesota are summarised in Table S1.

Methodology
To measure the impact of corn production on health, we followed the well-being valuation method explained in MARCH (FAO, 2017), which offers an alternative to the Quality-Adjusted Life Years (QALYs) approach of valuing the non-financial costs of health. To use this method, we first estimated the impact of a non-market good (in this case corn intensity), income, and other determinants of wellbeing on measures of subjective well-being (SWB), such as life satisfaction. Thus, as displayed in Figure S1, the wellbeing valuation method measures two effects: the impact of the non-market good on SWB ( ) and the impact of income on SWB ( ).
Consequently, using the estimated impacts of income and the non-market good, we assessed the monetary value of the non-market good. This monetary value shows how much an individual would have to be compensated to return their wellbeing to its original level (the status quo without the non-market good).
Figure S1 Graphical representation of the WV method for valuing corn intensity as a nonmarket good.
In this study, the non-market good being valued is corn intensity in the proximity of where individuals live and the measure of SWB is their life satisfaction (In the Gallup data, life satisfaction is measured by the Cantril ladder scale which poses the following question: "Please imagine a ladder with steps numbered from zero at the bottom to ten at the top. Suppose we say that the top of the ladder represents the best possible life for you and the bottom of the ladder represents the worst possible life for you. If the top step is 10 and the bottom step is 0, on which step of the ladder do you feel you personally stand at the present time?). The monetary value obtained through the wellbeing valuation method is the well-being effect of corn intensity through its impacts on health. This monetary value can also be interpreted as the (non-financial) costs of health associated with corn intensity. Note that the WV method does not account for any health impact caused by the consumption of products containing corn (as corn intensity can be assumed to be independent of the amount of corn consumed, not including corn consumption in the model does not bias our estimates).

Variables
We used following variables suggested in Fujiwara and Campbell (2011)

Monetary value
The valuation of non-financial health costs of corn production is based on the well-being valuation method. First, we estimate the impact of corn intensity (δ) on general health.
From Table S2, estimating the model using 5 km and 10 km buffers results in a value for δ of -0.0021 and -0.0025, respectively (statistically significant at the 5% level). The sign of δ indicates a negative association between experienced corn intensity and an individual's health. Based on these estimations, the negative impact is statistically significantly higher in the 10 km buffer compared with 5 km buffer. As the geographical area of a ZIP code is large (The average, minimum, and maximum values for the ZIP code geographic areas in Minnesota are 244 km 2 , 0.15 km 2 , and 289 km 2 ), particularly in rural areas, the corn intensity measured in a 10 km buffer more precisely represents the intensity experienced by individuals throughout the ZIP code area.
The value of δ implies that an increase in corn intensity in a 10 km buffer by 1% will decrease general health by 0.0025 points (where general health is measured by a 1-5 scale). Increasing the corn intensity by 9.74%, which is the average land used for corn production in 10 km buffer in our sample, implies a decrease of 0.024 points in general health. In other words, going from no corn production to the average level of corn production (holding other factors in the model constant) implies a 0.67% decrease in general health (relative to average levels of general health).
Consequently, we apply the wellbeing valuation method to estimate the non-financial health costs of corn intensity in the respondents' surrounding area. The non-financial health costs associated with a 1% increase in corn intensity in the vicinity of an individual's residence is $20.7 per year in the 5km buffer and $24.7 per year in the 10 km buffer. These results are based on Minnesota average household income 2016 which, according to US Census Bureau, was $83,100. Our analysis in this part reveals that although 26% of the sample have at least one organic farm with some corn production in their ZIP code, organic corn farms are particularly small on average comprising 0.3% of total land used for corn production. This means that the proportion of sample likely to be impacted on by an organic corn farm is much lower than that of a non-organic farm. The relatively lower size of organic corn farms might be an important issue in identifying the health impacts of organic versus non-organic corn production in case that we have access to a more complete and detailed data set.

Aggregating Health Costs:
To calculate annual non-financial health costs associated with corn production in Minnesota, we follow the following steps: 1. Using the wellbeing valuation method, we obtain the monetary value of the average health costs on individuals of a 1% increase in the intensity of corn production in their respective ZIP code. 2. Using data from the United States Census Bureau, we find the population for each county in Minnesota. The population of each county is then multiplied by the health costs obtained in step 1. This will give us the health costs per 1% corn intensity in each county. Note that our estimates are based on a sample of respondents aged over 18. If we assume that individuals aged under 18 are not affected differently by corn intensity, we multiply the whole population of each county to the health costs per individual. For example, for Dakota county, with a total population of 421,751, the annual health costs associated with a 1% increase in land used for corn in a 10 km buffer will be: 421,751 × $24.7 = $ 10.42 million. 3. To calculate the health costs of corn production per county, we multiply the number obtained in step 2 by average corn intensity for the county. For example, In Dakota county, the average corn intensity in a 10 km buffer is 8.63%, so the annual health costs of corn production are: 10.42 × 8.63 = $ 89.90 million a. Table S3 shows 40 counties with the highest health costs of corn production based on relative intensity in a 10 km buffer. 4. Finally, we find the total health costs in Minnesota by aggregating all counties health costs. Based on our model, the annual non-financial health costs of corn production in Minnesota are about $ 1.3 billion (approximately $233 per capita). This is broadly aligned with the costs obtained in MARCH (FAO, 2017). In this study, the annual nonfinancial health costs of the UK food system for different health problems were between $107 per capita and $1372 per capita.


Gender Determinant Factors for Bus Shelter Planning in Sustainable Urban Infrastructure

This article examines 14 factors related to mainstreaming gender for bus shelter planning in the creation of sustainable urban infrastructure in Semarang city. By conducting an interview survey of 70 male and female respondents, without being restricted by age, significant results were obtained in evaluating the performance of BRT shelters in the Corridor I Semarang using Crosstab technique. There are 4 gender determinant factors were resulted. Those are, in respective orders; availability of seats in the shelter, distance between the floor of the shelter and the bus body when riding/ descending passengers, the length of time waiting in the shelter, and the proximity of the location of the shelter to the pedestrian. It is clear that gender contributes to sustainable infrastructure as it gives equal access the perceptions, interests, needs and priorities of passengers to be weighted in planning and decision making.

Introduction
The theme of sustainable urban infrastructure has evolved from the context of urbanism, slums, and the degradation of urban space to the ecological perspective of artificial environments and urban networks. This includes how social and economic aspects influence the development of urban networks. In the field of transportation, a sustainable urban infrastructure includes four aspects of innovation such as new mobility, city logistics, intelligent system management, and live ability [1,2].
Based on the results of INRIX (a surveyor institution) study (2017) stated that the average congestion rate in the city of Semarang has reached 37 hours a year [3]. Therefore, public transportation modes are needed to facilitate the movement of the population. Demands for high mobility in the metropolitan area, must be balanced with transportation access that is able to meet the needs of all community groups. The mode of public transportation must pay attention to aspects of justice and equality, so that it can regulate share growth and reduce private vehicle use. The issue of BRT transportation access gaps in Semarang City was strengthened by 642 complaints related to the BRT which entered the complaint hotline through call center 1500094, Lapor Hendi, newspapers, SMS, and various social media @transsemarang during the period January to October 20, 2018 [4]. The majority of the complaints are related to the completeness and condition of public transportation facilities that have not paid attention to community needs. The gap in public transportation access could have an impact on the limited access of the community to carry out movements, thus inhibiting the community from accessing work, education, and social activities which in turn can reduce community productivity and economic growth in an area.
This article focuses on supporting facilities for the BRT movement in Semarang Corridor I, which is the conditions and quality of bus shelter, based on the results of field observations and analysis of the performance of its services. Why a bus shelter planning is important in the sustainable urban infrastructure? This is because bus shelter planning will influence the high and low crime rates [5][6][7]. Gender in transportation aims to ensure that the perceptions, interests, needs and priorities of women and men are given equal weight in planning and decision making in [8]. Based on that, most women depend on transportation public (formal and informal), which is often inefficient, uncomfortable, dirty, unreliable, poorly maintained and insecure. Public transportation and supporting facilities are important elements of sustainable transportation and efforts to reduce urban inequality. The social parameters of public transportation policies can be summarized into five, namely: Affordability, Availability, Acceptance, Accessibility [9,10] and Accuracy [8]. Accessibility refers to a number of opportunities available within a certain distance or trip, and conformity is related to local meaning and cultural gender norms. A nearby bus shelter may not be accessible because roads are not safe, heavy traffic, lack of protection from the sun or rain and or lack of seating. Therefore, sustainable urban infrastructure is related to the overall transportation environment and it starts with equitable public transportation facilities, accommodating the needs of its users. In the end, an urgent action need to be taken is how policy and planning program responded to gender norms in the form of bus shelter design and planning [5,11]. With equitable bus shelter planning, it means facilitating access to work, especially for female target groups. In another words, there is an opportunity to manage time between productive and reproductive roles in the household work [12]. This is becoming increasingly clear, and it is urgent that the planning of bus shelters need to be adjusted to the functions of user activity. Especially, if it is associated with travel behaviour conducted by men, women and other groups of user targets.

Methods
This study uses a survey research approach. The population was determined from the Semarang City BRT Corridor I users with a sample of 70 respondents; based on calculations using the Lameshow formula for infinite populations. Using gender perspective in the analysis means there is no need to equally divide the respondents, between men and women, but more importantly conducted depth observations to explore their perceptions and experiences in accessing the bus shelter performance.
The crosstab technique was conducted by looking at two aspects, i.e. security and comfort. Based on these two aspects, it was then constructed to 14 indicators based on the performance of BRT services in Corridor I Semarang. They are: (1) lighting in the shelter, (2) criminal acts, (3) availability of seats in the bus shelter, (4) cleanliness in the shelter related to garbage, (5) graffiti on the wall of the bus shelter, (6) smell inside the bus shelter, (7) the room temperature in the bus shelter, (8) the load capacity in the bus shelter, (9) the distance between the shelter floor and the bus body when riding / descending passengers, (10) availability of route related information, (11) tariff transparency (12) availability of schedules information, (13) length of waiting time, and (14) proximity to shelter locations with pedestrians. The crosstab is useful to determine the importance of these problems to be addressed immediately based on user needs. Respondents were asked the degree of important for the above variables, divided into 4 classifications. Namely: most important, important, less important and not important. Table 1 shows calculation results of each variable, based on the highest aspect points, for the overall classification (important, not important, very important and less important). This value is taken from the evaluation performance both in the male and female target groups. According to the calculation results using Crosstab method, it is depicted that in general, men assume that all above variables are less important. The scores are less than 10% for all the answered questions. Whereas, women tend to perceive that 4 variables are the most important and important aspects to be recommended for planning better bus shelter. Namely: (1) length of waiting time, (2) proximity to pedestrians, (3) the distance and height of the platform, and (4) the seat availability respectively.

Duration of Waiting Time in Shelter
The length of waiting time affects the level of security felt by the user. The longer the waiting time for transportation access, besides being able to influence the quantity of movement conducted; will also affects the higher risk of crime such as harassment and pickpocketing, especially at night or in quiet places [13]. It is clear that the length of the waiting time in the shelter is a very important variable for both groups. As it could affect the quantity of trips, they able to do. For group of female users, this can reduce their mobility in carrying out the dual roles they have, namely the productive and reproductive roles. Whereas, for group of men, the longer the waiting time could have them penalized or sanctioned from the workplace because of late arrival.
The Management of BRT Semarang City began to notice this recently, precisely on May 2, 2019 BLU UPTD Trans Semarang and Semarang City Government launched the Trans Semarang application by Android based. This service performs the whereabouts of upcoming buses and find out when the bus arrives. It helps to minimize waiting time for BRT users and reduce the risk of jostling at the shelter during rush hour because they are informed when the bus will arrive, so user could plan the trip on time effectively.

Proximity of The Location Of The Shelter To The Pedestrian
The proximity of the location of the shelter to the pedestrian is also a safety factor that needs to be considered in planning the construction of bus shelter. The location of the shelter that is close to the pedestrian could make it easier for users to access the shelter safely without fear of being hit by a vehicle that passes and does not disturb road traffic. This is because group of women tend to need public transportation which looks more at the comfort, security, and ease of access to public transportation modes [6,14]. Furthermore, this characteristic is urgent regarding to safety issues [15] suggested the important feature of exclusive BRT corridor to avoid accident cause by other transportation mode driver carelessness.

The Distance and Height of The Platform
The distance between the floor of the shelter and the bus body when the passenger is too far up /down can have an impact on the inconvenience for passengers, especially women. It is uncommon and not recommended for passengers to jump on riding [16]. This is because the distance between the platform and the bus body is considered too far which can endanger the passengers, and can disturb the comfort of the passengers, especially for women with tight clothing; making it difficult to move.
Although there has been an effort from the BRT manager with a service solution in the form of providing an officer inside the bus to help passengers whom have difficulty up / down. However, for some users, especially women, the elderly, people with disabilities, the presence of an officer does not help, during rush hour and overcrowding of passengers.

Availability of Seats in The Corridor I Shelter
The availability of seats in the shelter is one of the comfort factors that need to be considered in planning the construction of shelters. The reason is that it could reduce the risk of fatigue for the user due to the trip that is carried out while waiting for the bus arrival. So, it is mainly for health reason.
Availability of seats in the shelter is considered important for users, especially the female user group as much as 41.4%. This is related to the comfort of the user while waiting for the arrival of the bus. The result from field observations reveals the existence of a seat is still lacking and has not been able to meet user needs, which requires users to long stand waiting for the bus arrives.
On the contrary from explanations above, the following variables are classified less important to the user, both women and men. These are: (1) lighting in the shelter, (2) criminal acts, (3) cleanliness in the shelter related to garbage, (4) graffiti on the wall of the bus shelter, (5) smell inside the bus shelter, (6) the room temperature in the bus shelter, (7) the load capacity in the bus shelter, (8) availability of route related information, (9) tariff transparency, and (10) availability of schedules in the shelter.

Lighting
Lighting inside the shelter is one of the factors to improve security for public transport users [17]. Based on the results in Table 1 it is obvious that 41.4% of women consider that lighting in a bus stop is a less important variable to be addressed immediately. It is related to the operational hours of BRT services in Corridor I, which is only until 18:30 hr. Therefore, lighting in the bus stop is sufficient and does not become an important matter to be addressed immediately even if it is only obtained from street lighting.

Crime
Crime is one of the factors of insecurity in public transportation that can reduce the quantity of trips carried out by users, especially for groups of female users [18]. In accordance with the results of field observations and previous studies, it is often found that women are vulnerable to becoming victims of non-criminal crimes in public transportation such as harassment, pickpocketing, and other crimes compared to men. This can lead to limited access that women have to public transportation, so often they are afraid to travel alone, especially at night [18].
There is a decrease in the number of crimes related to crimes in the shelter based on the BLU data of the Trans Semarang UPTD in 2018. In addition, this is related to the hours of BRT services which only until 18.30 hour can minimize the occurrence of crime because of the uncrowded traffic on the Corridor route I. If the service hours are extended until night, the service route becomes quiet and the chance of criminal action increases.

Cleanliness
The cleanliness in the shelter in this study was classified into 3 aspects, namely cleanliness in the shelter from garbage, graffiti on the wall, and bad smell. Cleanliness in the shelter is an important factor of the comfort, perceived by women group. According to [19], and [20] it is recommended that women prefer infrastructure, with comfort and physical cleanliness [21].

Room Temperature
The temperature of the room inside the shelter is one of the comfort factors that need to be considered in planning a bus shelter. The indicator for a good bus shelter is that it provides a guarantee of comfort with the presence of shade from the sun and rain, so that the user is not experiencing hot temperature or wetness from rain, while waiting for the arrival of the bus. Based on Table 1, it is clear that the room temperature in the bus stop is considered quite good because 40.0% of users consider that the variable is not important to be addressed immediately. This is due to the design of the shelter in corridor I; the majority of which are open shelters, so that the room temperature is not hot due to air flow.

Load Capacity
Unattended load capacity can disrupt the user's comfort because it causes jostling in the bus. Overloaded passenger capacity increases the risk of abuse when the situation in public transportation is congested [17]. Based on Table 1 it reveals that the load capacity in the bus stop is considered less important for the female user group as much as 35.7%. This is because the majority of bus shelters in Corridor I are open spaces, so that if the load capacity inside the shelter is full, passengers can wait outside the shelter. So, passengers do not jostle and can minimize the risk of criminal acts, unlike when compared to closed places such as inside a bus, female users will feel insecure overcrowding in closed shelters.

Availability of Information Regarding routes, tariffs and departure arrival schedules
Availability of route information in the shelter is a supporting instrument that should be a priority. It aims to make easier to travel especially for novice passengers. The information helps them to change trips and inside or outside the shelter [22]; when and where to get in or get off from BRT.
Since the launch of a Trans Semarang BRT application, bus routes could be accessed via mobile phone which is more convenient for millennial user groups compared to reading  On the contrary, for passengers group, whom technological blind, the bus routes availability is considered important. In term of tariff, respondents weighted it less important because information related to tariffs has been installed in the fleet. Passengers could easily find out information on how much it costs. In addition, there are ticketing officers at several shelters who tell the passengers what rates to pay. This confirms the statement of Deng & Nelson [15], stated that fare, schedule, service frequency and ticketing mechanism could improve the passengers flow.

Conclusions
It is clear that crosstab analysis helps to prioritize the important aspect in planning of better bus shelter, especially in Corridor I with regard to the needs of each user group, namely the availability of seats in the shelter, the distance between the shelter floor and the body the bus when riding / descending passengers, the length of time waiting in the shelter, and the proximity of the location of the shelter to the pedestrian. The less important aspects which consisting of 10 other variables are included in the security and comfort as predominant factors in constructing bus shelter. The evaluation of bus shelter performance of BRT Corridor I Semarang proves to be sufficient and confirm the relationship between the availability of adequate, complete and effective functions to support the passengers movement. As the end result, the role of good bus shelter planning supportS the creation of a sustainable urban infrastructure. The reason why gender is important for planning better sustainable bus shelter, as it conveys perceptions and experiences dealing with BRT performance. In short, gender perspective ensures that the critical aspects are effectively addressed. Therefore, knowing the needs of each group of users related to shelter facilities in this study can be used to plan better transportation for the creation of justice and gender equality.