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Background More than one million people each year become infected by parasites that cause the disease cutaneous leishmaniasis (CL). This disease manifests as one or more skin lesions or ulcers that are slow to heal with variable response rates to drug treatments. Thus far, little attention has been paid to how the cultural effects of gender shape perceptions and experiences of CL. This review aims to bring together and analyse existing studies which use qualitative data to explore these differences. These studies offered insights into our specific research questions. Methods We conducted a systematic review of the literature pertaining to either CL or muco-cutaneous leishmaniasis (MCL) through EBSCO, EMBASE, Medline, Scopus and Web of Science databases. To meet inclusion criteria, articles had to be either qualitative or mixed-method with a qualitative component. They also had to include a reflection on how the gender of participants impacted the findings and addressed the lived experiences of CL. We did not exclude articles based on the language they were published in or in which country the study took place. Results From a total of 1589 potential articles, we found that thirteen met the inclusion criteria. These articles were published in English, Spanish or Portuguese and reported on studies carried out in various countries in Africa, Asia and South America. After using the principles of a meta-ethnography to analyse these studies, we generated several key themes. We found that health-seeking behaviours, treatment choices, stigma and the impact of scarring are shaped by gender in a variety of contexts. Conclusions Gender impacts on an individual’s experience of CL. In particular, women are more constricted in their health-seeking behaviours and experience more stigma both from the active lesions and from scarring than men. In many contexts, however, men are more at risk of becoming infected by the parasite that causes CL and may turn to more harmful or aggressive self-treatments. We recommend that future research on CL should consider the impact of gender as this can create very different experiences for individuals.

We researched how CSO s working in the area of sustainable development responded to regulatory restrictions on advocacy work using Ethiopia as a case study. We found that the restrictive laws had a severe impact: many CSO s had to shut down or limit their operational capacity to service delivery only. Those that survived continued to do advocacy work, disguised as service delivery. This shows that northern stakeholders should not adhere to a strict division between advocacy and service delivery in their funding policy. They also should focus on long-term CSO engagement and long-term CSO funding. In 2019, regulatory reform reopened political space to some extent. The new law envisions a greater role for self-regulation in the civil society sector while still maintaining some degree of State oversight through registration, reporting and funding allocation requirements. Despite these improvements, the sector is still in need of international support and consistent and reliable funding.

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