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BACKGROUND: Policies that empower individuals and communities may be appropriate for public health, and more broadly. Simple, transparent and acceptable tools are therefore required to evaluate policies from an empowerment perspective. In 2008, the South African Department of Health (DOHSA) drafted a policy to endorse the integration of African Traditional Medicine (ATM) into the public health sector, following the World Health Organization's (WHO) long-standing directives. OBJECTIVE: The purpose of this study is to critically analyze this policy using a novel evaluation tool. DESIGN: A 12-point 'Policy Empowerment Index' (PEI) is introduced, and used to classify and score the policy according to five theoretical policy types. The evaluation was based on a stepwise review and associated publications: policy drafts, policy statements and news announcements. RESULTS: According to the assessment tool, the ATM policy was marginally 'supportive' of constituent empowerment, although several 'directive' features were also observed. The importance of ATM to SA's communities and the promotion of education, employment, entrepreneurship and peripheral resource mobilization were the main empowering elements. Centralised conception, planning and implementation, the absence of provisions for local adaptations and the authoritative legislation context were sub-optimal features. CONCLUSIONS: South Africa's ATM legislation may need to further involve communities in policy design and implementation to capitalise upon the broader benefits of community empowerment. However, the iterative nature of method and evaluation is important. Indeed, they are proposed as points to initiate participatory development, and improve policy evaluation. Such instruments can empower constituents in the political process.

Psychosocial stress could lead to a wide range of possible physiological reactions, due to both the total burden of stress as well as individual susceptibility. Two useful Swedish registers to investigate early life influences on stress susceptibility are the Swedish Medical Birth Register (MBR) and the Military Service Conscription Register (MSCR). In a previous study we showed a positive relation between fetal growth and psychological functioning (PF) including an assessment of stress susceptibility.1 However, in that study we did not adjust for family social class—nor did another related study.2 We have therefore now carried out such an analysis in an expanded cohort study, by adding parental educational level as a marker of family social class. The aim was to investigate independent associations between fetal growth and stress susceptibility in young men.

Abstract Background About half a billion people with disabilities in developing countries have limited access to assistive technology. The Convention on the Rights of persons with Disabilities requires governments to take measures to ensure provision of such technologies. To guide implementation of these measures there is a need for understanding health outcomes from a human rights perspective. The objective of this study was therefore to explore the relation between assistive technology use and enjoyment of human rights in a low-income country. Methods Data was collected in eight districts of Bangladesh through interviews of people with hearing impairments using and not using hearings aids, and people with ambulatory impairments using and not using manual wheelchairs (N = 583). Using logistic regression, self-reported outcomes on standard of living, health, education, work, receiving information and movement were analyzed. Results The adjusted likelihood of reporting greater enjoyment of human rights was significantly higher among people using hearing aids compared to non-users for all outcomes except working status. Compared to non-users, users of wheelchairs reported a significantly higher adjusted likelihood of good ambulatory performance and a significantly lower adjusted likelihood of reporting a positive working status. Further analyses indicated that physical accessibility to working places and duration of wheelchair use had a statistically significant impact on the likelihood of reporting positive work outcomes. Conclusions The findings support the notion that assistive technology use increases the likelihood of human rights enjoyment, particularly hearing aid use. Physical accessibility should always be addressed in wheelchair provision.

Purpose: About half of all people with disabilities in developing countries live in extreme poverty. Focusing on the ends rather than the economic means of human development, the capability approach offers an alternative view of poverty. The purpose of this study was to explore the relation between assistive technology use and capability poverty in a low-income country. Method: Self-reported data on food intake, health care, education, politics, self-determination, self-respect, family relationships and friendships were collected in Bangladesh through interviews of people with hearing impairments using and not using hearings aids, and people with ambulatory impairments using and not using manual wheelchairs (N = 583). Differences in outcomes between users and non-users of assistive technology were analyzed using logistic regression. Results: Assistive technology users were more likely than non-users to report enhanced capabilities, hearing aid users to a larger extent than wheelchair users. Synergistic effects between assistive technology use and education were found. Conclusion: The use of assistive technology is predictive of reduced capability poverty in Bangladesh. Lack of wheelchair accessibility and the nature of selected outcomes may explain the limited association in the ambulatory group. Enhancing the effects of the other, there is support for providing education in combination with hearing aids.

Background: About half a billion people with disabilities in developing countries have limited access to assistive technology. The Convention on the Rights of persons with Disabilities requires governments to take measures to ensure provision of such technologies. To guide implementation of these measures there is a need for understanding health outcomes from a human rights perspective. The objective of this study was therefore to explore the relation between assistive technology use and enjoyment of human rights in a low-income country. Methods: Data was collected in eight districts of Bangladesh through interviews of people with hearing impairments using and not using hearings aids, and people with ambulatory impairments using and not using manual wheelchairs (N = 583). Using logistic regression, self-reported outcomes on standard of living, health, education, work, receiving information and movement were analyzed. Results: The adjusted likelihood of reporting greater enjoyment of human rights was significantly higher among people using hearing aids compared to non-users for all outcomes except working status. Compared to non-users, users of wheelchairs reported a significantly higher adjusted likelihood of good ambulatory performance and a significantly lower adjusted likelihood of reporting a positive working status. Further analyses indicated that physical accessibility to working places and duration of wheelchair use had a statistically significant impact on the likelihood of reporting positive work outcomes. Conclusions: The findings support the notion that assistive technology use increases the likelihood of human rights enjoyment, particularly hearing aid use. Physical accessibility should always be addressed in wheelchair provision.