Introduction

The Fleming Fund (FF) is a U.K. Department of Health and Social Care programme to help low and middle-income countries fight Antimicrobial Resistance (AMR). AMR poses a severe global threat, expected to cause 10 million deaths annually by 2050. With potential costs reaching $100 trillion, its impact on the global economy is significant. Fleming Fund Grants aim to tackle the AMR challenge in developing countries including Pakistan. The grants are funded by the UK Department of Health and Social Care and managed by Mott MacDonald for the country, regional and fellowship grants. Pakistan has received Fleming Fund support since 2019 in the form of two Country Grants, 9 Fellowships, and central and local procurement of equipment, reagents, and consumables. Between 2017 and the end of phase-1 of the program in March 2023, the program has provided financial support to grantees to establish and support local development of national AMR surveillance systems.

In partnership with the Fleming Fund, DAI's programme in Pakistan collaborates with the Pakistani government to strengthen systems using a “One Health” (OH) approach – a multisectoral approach to complex health problems that reaches across human health, animal health, and environment sectors. As global leaders in One Health, the DAI team helps incorporate One Health across programme interventions. DAI is helping Pakistan become a leader in combating antimicrobial resistance, and a model for better management of antimicrobials in human and animal populations. DAI and its consortium partners have successfully secured an additional round, Phase 2, of the Fleming Fund Country Grant in Pakistan which spans from January 2024 to December 2025. The Phase 2 of the FFCG programme focuses on achieving four intermediate outcomes: 1) Production of quality AMR/U/C and burden of disease data; 2) Conducting quality data analysis; 3) Sharing quality data analysis with decision-makers; and 4) Contributing to sustainable investments at both the country and global levels to counter AMR.

Position Summary

This STTA aims to investigate the differences in antimicrobial use in human males and females and its implications for AMR. The STTA consultant will provide expert guidance and support for a comprehensive study examining gender-specific patterns in antimicrobial use. This position involves leading the design, implementation, and analysis phases of the study, ensuring that all activities are conducted with a focus on gender sensitivity and methodological rigor.

Overall Objective

To provide technical expertise in conducting a gender-segregated study on antimicrobial use to identify and analyze gender disparities in antimicrobial access, use, and outcomes. The STTA will contribute to the development and implementation of gender-responsive interventions study to address these disparities.

Specific Objectives

1. Develop a robust study protocol and methodology.
2. Develop appropriate data collection tools and instruments to capture relevant data and information.
3. Gather teams, train them and collect data.
4. Conduct in-depth analysis to identify gaps among sexes in antimicrobial use as well as underlying factors contributing to disparities.
5. Contribute to the development of gender-sensitive recommendations for policy and program implementation.

By achieving these objectives, the STTA will significantly contribute to the understanding of gender-based inequities in antimicrobial use and inform evidence-based interventions to improve antimicrobial stewardship and public health outcomes.

Scope of Work

The STTA will cover the following key areas:

1. Review of Existing Data 

• Assess available data on antimicrobial use in humans disaggregated by sex.
• Identify gaps and inconsistencies in the current data.
• Develop a comprehensive study design, including research questions, objectives, and methodology tailored to the specific context of Pakistan.

1. Data Collection and Analysis 

• Design and implement data collection strategies to gather sex-specific data on antimicrobial use.
• Identify appropriate data collection methods (e.g., surveys, interviews, focus groups, observational studies) considering cultural and socio-economic factors.
• Develop data collection tools (e.g., questionnaires, interview guides) that are gender-sensitive, culturally appropriate, and aligned with the study objectives.
• Determine sample size and sampling methodology based on study objectives and considering potential gender disparities in the target population.
• Gather a team of data collectors, train them and supervise & manage data collection.
• Analyze the data to identify patterns, trends, and determinants of antimicrobial use among males and females. 

1. Recommendations and Reporting

• Prepare a comprehensive report detailing findings, analysis, and recommendations.
• Develop evidence-based recommendations for gender-sensitive antimicrobial stewardship programs.
• Present findings to key stakeholders and facilitate a workshop to discuss implications and action plans.

Assignment Deliverables

1. Inception Report: A comprehensive document summarizing the outcomes of the inception meeting, detailing the study's specific objectives, scope, methodology, timeline, roles and responsibilities, ethical considerations, risk management strategies, and communication plan.
2. Data Collection Tools: Development of gender-sensitive surveys, interview guides, and focus group discussion protocols tailored to gather quantitative and qualitative data on antimicrobial use among different genders.
3. Training Materials: Creation of manuals and presentations for training data collectors on gender-sensitive data collection methods, ensuring consistency and accuracy in data gathering.
4. Interim Progress Reports: Periodic reports detailing the progress of data collection, initial findings, challenges encountered, and any adjustments made to the study plan, keeping stakeholders informed and engaged.
5. Draft Report: A preliminary report presenting initial findings, data analysis, and recommendations, which will be shared with stakeholders for validation and feedback.
6. Final Report: A comprehensive report that incorporates stakeholder feedback, providing a detailed analysis of gender-specific patterns in antimicrobial use, socio-cultural influences, healthcare access, and knowledge and attitudes towards AMR, along with actionable recommendations.
7. Policy Briefs: Concise documents summarizing the key findings and recommendations of the study, tailored for policymakers to inform and influence policy and practice changes regarding antimicrobial use.
8. Dissemination Workshop: Coordinating a workshop and preparation of presentation slides and other materials for workshop to disseminate the study findings to a broader audience, including healthcare providers, researchers, and the community.

Requirements (Education, Experience, Skills, Languages etc.)

• Hold a Master's or higher degree in public  health, gender studies, social sciences, or other relevant fields,
• Have a minimum of 10 years of experience.
• He/she should demonstrate a robust track record of developing complex multi-sectoral Gender Strategies and/or Gender mainstreaming, particularly within the public  health sector.
• The candidate is expected to possess a deep understanding of the Research Studies in AMR/One Health sector in Pakistan, including familiarity with challenges related to inequities, in particular gender inequalities.
• The individual should showcase proven expertise in facilitating participatory approaches and effectively engaging diverse stakeholders within both public and private sectors
• Excellent written, editing, and oral communication skills in English are imperative.