Evidence map›Paper›PMID 41915706›Full record

ArticleHealth policy and planning2026

Applying a gender and equity matrix for a contextualized antimicrobial stewardship intervention in Pakistan.

Saad Alam Khan, Muhammad Ahmar Khan, Ingrid Lynch, Nida Khan, Shaheer Ellahi Khan, Farah Zafar, Cèlia Ventura-Gabarró, Erica Westwood, Anna Kalbarczyk, Rosemary Morgan and 1 more

Abstract read
In one paragraph

Article in Health policy and planning, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Saad Alam KhanResearch, Monitoring, and Evaluation Unit, Association for Social Development, House No. 12, Street 48, Sector F-7/4, Islamabad 44000, Pakistan.
Muhammad Ahmar KhanResearch, Monitoring, and Evaluation Unit, Association for Social Development, House No. 12, Street 48, Sector F-7/4, Islamabad 44000, Pakistan.
Ingrid LynchDepartment of Psychology, Rhodes University, P O Box 94, Makhanda (formerly Grahamstown) 6140, South Africa.
Nida KhanResearch, Monitoring, and Evaluation Unit, Association for Social Development, House No. 12, Street 48, Sector F-7/4, Islamabad 44000, Pakistan.ORCID 0000-0002-2881-2153
Shaheer Ellahi KhanHealth Services Academy, Prime Minister's National Health Complex, Near NIH, Park Road, Chak Shahzad, Islamabad 44000, Pakistan.
Farah ZafarResearch, Monitoring, and Evaluation Unit, Association for Social Development, House No. 12, Street 48, Sector F-7/4, Islamabad 44000, Pakistan.
Cèlia Ventura-GabarróScience Department, International Centre for Antimicrobial Resistance Solutions, Ørestads Boulevard 5, 2300 Copenhagen S, Denmark.
Erica WestwoodScience Department, International Centre for Antimicrobial Resistance Solutions, Ørestads Boulevard 5, 2300 Copenhagen S, Denmark.
Anna KalbarczykBloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, United States.ORCID 0000-0002-6143-8634
Rosemary MorganBloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, United States.ORCID 0000-0001-5009-8470
Muhammad Amir KhanResearch, Monitoring, and Evaluation Unit, Association for Social Development, House No. 12, Street 48, Sector F-7/4, Islamabad 44000, Pakistan.

Funding

International Centre for Antimicrobial Resistance Solutions 100023_110
6 · The paper itself

Abstract

Antimicrobial resistance (AMR) is a growing global health threat that extends beyond biomedical dimensions, as it is profoundly shaped by social and structural determinants such as gender, socioeconomic status, and access to care. However, research exploring these factors remains limited. This study adapts and applies a gender and equity matrix to examine how these factors intersect to affect AMR risks in rural Pakistan. We synthesized literature on antibiotic prescription and use in Pakistan and similar sociocultural and economic context settings, focusing on upper respiratory tract and diarrhoeal infections. We then integrated these findings with insights from a structured consultation with gender and public health experts. The gender and equity matrix mapped inequities across three topic-specific domains-susceptibility/vulnerability to infection, care provision (during facility visits), and care uptake (before and after facility visits)-cross-referenced with biological and social stratifiers along with gender analysis domains. Findings were synthesized into cross-cutting themes to identify actionable drivers of AMR. The context analysis highlighted persistent gender- and equity-related barriers in access to care, including women's limited mobility, lower health literacy, and restricted decision-making autonomy. We also identified structural constraints, including limited household financial resources that result in women being deprioritized for care, alongside gender-insensitive health care service delivery. In rural low- and middle-income countries' settings, addressing these barriers requires gender-responsive health system design, equitable provider-patient communication, and interventions that reduce economic and physical barriers to care uptake. The gender and equity matrix offers a structured approach to reveal how social and structural determinants interact to drive AMR risks, providing a practical tool for systematically integrating gender and equity considerations into AMR policy and programming.

Indexed as

Anti-Bacterial AgentsAntimicrobial StewardshipGender EquityFemaleHealth Services AccessibilityHumansMalePakistanRural PopulationSex FactorsAnti-Bacterial Agentsantimicrobial resistancecontextequitygendermatrixrural

Identifiers

PMID41915706
PMCPMC13187641

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.