Gender differences in antibiotics use behaviour and access to antibiotics in low- and middle-income countries: a scoping review protocol

Background In low-and middle-income countries (LMICs), the persistent lack of access and high inappropriate use of antibiotics, which are fuelled by gender-related factors continue to facilitate antimicrobial resistance which in turn reduces the capacity to treat infectious diseases. However, there is lack of sufficient clarity on the nature and extent of gender influence on access to antibiotics and antibiotic use behaviour. This proposed study aims to systematically review available literature in order to map out the nature and extent of evidence on gender differences and related factors influencing antibiotics use behaviour and access to antibiotics in LMICs. Methods This scoping review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for scoping reviews. The MEDLINE, PsycINFO, African Journal Online (AJOL), Web of Science and CINAHL databases will be searched for peer-reviewed articles and relevant electronic grey literature will also be included in the study. The Rayyan application software will be utilized for data extraction and analysis. Findings will be presented in narrative summary and tables. Conclusion It is expected that this study will identify knowledge and gaps on gender contributory factors to antibiotics use and access to antibiotics. These will contribute to understanding gender health inequalities and areas for further research on gender mainstreaming in antimicrobial stewardship efforts in the LMICs. This study findings will be disseminated through presentations in scientific conferences and publications in peer-reviewed journals. Scoping review registration Registration DOI: https://doi.org/10.17605/OSF.IO/N5W8E ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The authors received no specific funding for this work. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Not applicable I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable Research data will be submitted as supplementary materials to be published when the study is completed.