Background:
Meta-ethnography is a commonly used methodology for qualitative evidence synthesis. Research has identified that the quality of reporting of published meta-ethnographies is often poor and this has limited the utility of meta-ethnography findings to influence policy and practice.

Objective(s):
To develop guidance to improve the completeness and clarity of meta-ethnography reporting.

Methods / Design
The eMERGe study followed the recommended approach for developing health research reporting guidelines and used a systematic mixed methods approach. It comprised of: (1) a methodological systematic review of guidance in the conduct and reporting of meta
-ethnography; (2) a review and audit of published meta-thnographies, along with interviews with meta-ethnography end-users, to identify good practice principles; (3) A consensus workshop and two eDelphi studies to agree guidance content; (4) development of the guidance table and explanatory notes.

Results
Results from the methodological systematic review and the audit of published meta-ethnographies revealed that more guidance was required around the reporting of all phases of meta-ethnography conduct, and in particular, the synthesis phases 4-6 (relating studies, translating studies into one another and synthesising translations). Following the guidance development process, the eMERGe Reporting Guidance was produced, consisting of 19 items grouped into the 7 phases of meta-ethnography.

Limitations
The finalised Guidance has not yet been evaluated in practice, therefore it is not possible at this stage to comment on their utility. However, we look forward to evaluating their uptake and usability in the future.

Conclusions
The eMERGe Reporting Guidance has been developed following a rigorous process in line with guideline development recommendations. The guidance is intended to improve the clarity and completeness of reporting of meta-ethnographies, to facilitate use of their findings to inform the design and delivery of services and interventions in health, social care and other iv fields. The eMERGe project developed a range of training material to support use of the guidance, which is freely available at www.emergeproject.org.

Future work
Meta-ethnography is an evolving qualitative evidence synthesis methodology, and future research will refine the guidance to accommodate future methodological developments. We
will also investigate the impact of the eMERGe reporting guidance with a view to updating the guidance.