Landscape analysis reports on gender, equity and AMR
As the GEAR up project comes to an end in 2026 we have synthesised learning from across our focus countries or surveyed the landscape.
The aim was to identify key themes relating to gender, equity and AMR across One Health and to highlight gaps and opportunities for more inclusive action in AMR programming and provide context-specific recommendations to mainstream gender and equity. It is hoped that this evidence will be taken up by other researchers and decision-makers to change the way that we approach the problem of AMR.
The key questions guiding these landscape analyses include: a) How does antibiotic resistance differentially affect men, women, children and people of diverse sex in terms of diseases and treatments over the life course? b) Do any social groups face greater/different risks to AMR exposure or more challenges in accessing and benefiting from the information, services and solutions to tackle AMR? c) What are the gaps and opportunities for mainstreaming within country systems, policies and contexts and to support the vulnerable groups identified above?
Uganda
This report was prepared by Anne Ngunjiri, Susan Okioma, Sammy Gachigua, Pacific Owuondo, Jane Thiomi, Michael Gaitho, Anthony Mwaniki and Dr Cleophas Ondieki led this analysis. The report was supported by Rosie Steege and Katy Davis. The work benefited from the research team’s commitment, whose contributions strengthened the study’s rigour and future relevance. The team included Cynthia Owino, Jacquey Happy Odhiambo, Naumy Mumo, Perez A. Inda, Olum Haningtone, Gladwell Ngunjiri, Plista A. Anyango, Christine A. Omoya, James Serembe, Dora Bloch, Evans Owino, Brian Waka, Peter Kariuki, Evans Mchesia, Gloria Gwengi Obiero and Mercy Kihiu. Their engagement supported the development of evidence that will inform more inclusive approaches to antimicrobial resistance governance. We acknowledge the National AMR Secretariat in Uganda under the Ministry of Health, whose documents supported the policy review for Uganda.
The analysis draws on a structured review of 12 national AMR policy documents and technical surveillance tools from Uganda. A 12-domain Gender and Equity assessment framework, informed by global guidance, was applied to assess the integration of inclusive principles into AMR governance, surveillance, and implementation. Insights from multisectoral stakeholder roundtables, which focused on gender and equity integration in AMR strategies contributed to the findings.
Indonesia
This report was prepared by Ralalicia Limato of GEAR up, Liverpool School of Tropical Medicine, with support from Rosie Steege and Katy Davis and in close collaboration with Saraswati, the Fleming Fund Country Grant Indonesia, and the Ministry of Health of the Republic of Indonesia.
This study highlights that gender and equity are not adequately addressed in Indonesia’s AMR response. The current National Action Plan on AMR (NAP-AMR) and hospital-level AMR policies do not explicitly address equity dimensions. Efforts to address AMR also remain heavily hospital-centred, with most interventions focused on inpatient care. Where equity is considered, it is often interpreted as equitable access to healthcare services. Monitoring and evaluation rely mainly on hospital accreditation processes, which track technical compliance but do not systematically assess equitable access or gendered patterns of antibiotic use.
Addressing these gaps requires the explicit integration of gender and equity into AMR policy frameworks. Stronger leadership from the Ministry of Health is needed to direct hospitals and AMR programme implementers to adopt equity-sensitive approaches. National policies should be complemented by community engagement strategies, empowering parents and local actors to participate in addressing AMR. Clinical guidelines should embed gender and equity considerations, particularly for conditions such as urinary tract infections, tuberculosis, and HIV, where sex and gender dimensions significantly shape risks and treatment outcomes.
