Gender and equity considerations in AMR research: a systematic scoping review.

Research on gender and antimicrobial resistance (AMR) beyond women's biological susceptibility is limited. A gender and equity lens in AMR research is necessary to promote gender equality and support the effectiveness, uptake, and sustainability of real-world AMR solutions. We argue that it is an ethical and social justice imperative to include gender and related intersectional issues in AMR research and implementation. An intersectional exploration of the interplay between people's diverse identities and experiences, including their gender, socio-economic status, race, disability, age, and sexuality, may help us understand how these factors reinforce AMR risk and vulnerability and ensure that interventions to reduce the risk of AMR do not impact unevenly. This paper reports on the findings of a systematic scoping review on the interlinkages between AMR, gender and other socio-behavioural characteristics to identify priority knowledge gaps in human and animal health in LMICs. The review focused on peer-reviewed and grey literature published between 2017 and 2022. Three overarching themes were gendered division of caregiving roles and responsibilities, gender power relations in decision-making, and interactions between gender norms and health-seeking behaviours. Research that fails to account for gender and its intersections with other lines of disadvantage, such as race, class and ability, risks being irrelevant and will have little impact on the continued and dangerous spread of AMR. We provide recommendations for integrating an intersectional gender lens in AMR research, policy and practice.

"I felt like I was going to cause conflict. So, I kept quiet " (Female child rape victim, 15 years).

BACKGROUND: There is limited research in South Africa that has analysed the experiences of child and youth victims of crime and sexual victimisation who accessed formal response services through the victim empowerment programme. OBJECTIVE: The primary aim of this article is to explore children and youth's experiences of accessing the Victim Empowerment Programmatic services, through the criminal justice system in South Africa. The focus of the article is on childrens' disclosure, reporting and social support. PARTICIPANTS AND SETTING: The participants in the study are male and female victim/survivor of crime between the ages of 12-17 years who has been through a Victim Empowerment Programme (VEP) for at least 12 months. The Victim Empowerment Programme is a governmental programme located within the National Department of Social Development in South Africa. METHOD: The full study is a mixed method study but the children's(youth) participation in the study is limited to qualitative methods. The data analysis utilised a thematic approach and ATLAS.ti software. RESULTS: The findings revealed four themes, namely, (1) children's (as youth) perceptions of the presence and frequency of rape in communities, (2) disclosure and reporting rape; (3) interlinkage of disclosure and reporting of child rape and child sexual victimisation; and (4) seeking social and professional support to deal with the trauma of child (youth) rape and child sexual victimisation. The findings showed that children (youth) perceive their community environments as unsafe spaces where they are exposed to crimes such as rape and burglary; that there are delays in disclosure of sexual victimisation and victims/survivors are still dealing with the trauma of rape as they report the crime and navigate the pathways of the criminal justice system. CONCLUSION: In conclusion, this study confirms the delay in disclosure of childhood (youth) sexual victimisation and identifies the complex tension for children (youth) who disclose, that they are often pressured to report the crime, and journey through an adversarial criminal justice system, and so 'breaking the silence' is often unpredictable and emotionally and psychologically costly for children and youth.