Background Childhood vaccination is one of the most effective ways to prevent serious illnesses and deaths in children. However, worldwide, many children do not receive all recommended vaccinations, for several potential reasons. Vaccines might be unavailable, or parents may experience difficulties in accessing vaccination services; for instance, because of poor quality health services, distance from a health facility, or lack of money. Some parents may not accept available vaccines and vaccination services. Our understanding of what influences parents’ views and practices around childhood vaccination, and why some parents may not accept vaccines for their children, is still limited. This synthesis links to Cochrane Reviews of the effectiveness of interventions to improve coverage or uptake of childhood vaccination. Objectives ‐ Explore parents’ and informal caregivers’ views and practices regarding routine childhood vaccination, and the factors influencing acceptance, hesitancy, or nonacceptance of routine childhood vaccination. ‐ Develop a conceptual understanding of what and how different factors reduce parental acceptance of routine childhood vaccination. ‐ Explore how the findings of this review can enhance our understanding of the related Cochrane Reviews of intervention effectiveness. Search methods We searched MEDLINE, Embase, CINAHL, and three other databases for eligible studies from 1974 to June 2020. Selection criteria We included studies that: utilised qualitative methods for data collection and analysis; focused on parents’ or caregivers’ views, practices, acceptance, hesitancy, or refusal of routine vaccination for children aged up to six years; and were from any setting globally where childhood vaccination is provided. Data collection and analysis We used a pre‐specified sampling frame to sample from eligible studies, aiming to capture studies that were conceptually rich, relevant to the review's phenomenon of interest, from diverse geographical settings, and from a range of income‐level settings. We extracted contextual and methodological data from each sampled study. We used a meta‐ethnographic approach to analyse and synthesise the evidence. We assessed methodological limitations using a list of criteria used in previous Cochrane Reviews and originally based on the Critical Appraisal Skills Programme quality assessment tool for qualitative studies. We used the GRADE‐CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach to assess our confidence in each finding. We integrated the findings of this review with those from relevant Cochrane Reviews of intervention effectiveness. We did this by mapping whether the underlying theories or components of trial interventions included in those reviews related to or targeted the overarching factors influencing parental views and...

To determine the effects of community-level interventions that aim to improve access to nutritious food in LMICs, for both the whole community and for disadvantaged or at-risk individuals or groups within a community, such as infants and children, women, the elderly, the poor, the unemployed, or minority groups. Secondary objectives To determine the features of community-level interventions that enable or impede the effective implementation of these interventions to improve access to food. To identify unintended consequences of interventions to improve access to food. B A C K G R O U N D Description of the condition Food security exists when "all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life" (FAO 2003). When this is not the case, the population is said to be food insecure. Food insecurity and associated undernutrition affect health and socioeconomic development on different levels (Black 2013; Ecker 2012; Victora 2008). For adults it has been associated with increased risk of disability, morbidity and mortality, and with income generating potential (Black 2008, Black 2013, Victora 2008). 1 Community-level interventions for improving access to food in low-and middle-income countries (Protocol)

Background A well‐functioning routine health information system (RHIS) can provide the information needed for health system management, for governance, accountability, planning, policy making, surveillance and quality improvement, but poor information support has been identified as a major obstacle for improving health system management. Objectives To assess the effects of interventions to improve routine health information systems in terms of RHIS performance, and also, in terms of improved health system management performance, and improved patient and population health outcomes. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE Ovid and Embase Ovid in May 2019. We searched Global Health, Ovid and PsycInfo in April 2016. In January 2020 we searched for grey literature in the Grey Literature Report and in OpenGrey, and for ongoing trials using the International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov. In October 2019 we also did a cited reference search using Web of Science, and a ‘similar articles’ search in PubMed. Selection criteria Randomised and non‐randomised trials, controlled before‐after studies and time‐series studies comparing routine health information system interventions, with controls, in primary, hospital or community health care settings. Participants included clinical staff and management, district management and community health workers using routine information systems. Data collection and analysis Two authors independently reviewed records to identify studies for inclusion, extracted data from the included studies and assessed the risk of bias. Interventions and outcomes were too varied across studies to allow for pooled risk analysis. We present a 'Summary of findings' table for each intervention comparisons broadly categorised into Technical and Organisational (or a combination), and report outcomes on data quality and service quality. We used the GRADE approach to assess the certainty of the evidence. Main results We included six studies: four cluster randomised trials and two controlled before‐after studies, from Africa and South America. Three studies evaluated technical interventions, one study evaluated an organisational intervention, and two studies evaluated a combination of technical and organisational interventions. Four studies reported on data quality and six studies reported on service quality. In terms of data quality, a web‐based electronic TB laboratory information system probably reduces the length of time to reporting of TB test results, and probably reduces the overall rate of recording errors of TB test results, compared to a paper‐based system (moderate certainty evidence). We are uncertain about the effect of the electronic laboratory information system on the recording rate of serious...

As rates of novel coronavirus disease 2019 (COVID-19) continue rising in Africa, usage of infection prevention and control (IPC) strategies by healthcare workers (HCW) is critical. We highlight a Cochrane review of qualitative evidence that explored barriers and facilitators to HCW compliance with IPC recommendations for COVID-19 and other respiratory infectious diseases. The review found various individual- and organizational- level barriers and facilitators. The findings suggest that healthcare system constraints that make it difficult for healthcare workers to implement IPC guidelines require urgent prioritisation. This will help lay the foundation for addressing the more individual-level barriers potentially discouraging HCW from implementing IPC guidelines. We draw attention to pan-African initiatives for enhancing healthcare workers’ capacity to undertake IPC measures at such a critical time.

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To determine the effects of community-level interventions that aim to improve access to nutritious food in LMICs, for both the whole community and for disadvantaged or at-risk individuals or groups within a community, such as infants and children, women, the elderly, the poor, the unemployed, or minority groups. Secondary objectives To determine the features of community-level interventions that enable or impede the effective implementation of these interventions to improve access to food. To identify unintended consequences of interventions to improve access to food. B A C K G R O U N D Description of the condition Food security exists when "all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life" (FAO 2003). When this is not the case, the population is said to be food insecure. Food insecurity and associated undernutrition affect health and socioeconomic development on different levels (Black 2013; Ecker 2012; Victora 2008). For adults it has been associated with increased risk of disability, morbidity and mortality, and with income generating potential (Black 2008, Black 2013, Victora 2008). 1 Community-level interventions for improving access to food in low-and middle-income countries (Protocol)

COVID-19 is a new, rapidly emerging infectious disease that the World Health Organization (WHO) has classified as a pandemic. The virus is transmitted through droplets generated when an infected person coughs, sneezes or exhales. One big challenge with containing the transmission of COVID-19 is that there are currently no effective pharmacological interventions or vaccines to treat or prevent the disease. The WHO has therefore recommended nonpharmacological public health measures, such as isolation, social distancing and quarantine. The South African (SA) government has followed the WHO's recommendations, resulting in a nationwide lockdown. This Cochrane Corner article summarises findings from a rapid review on the effectiveness of quarantine during serious coronavirus outbreaks, to support recommendations on quarantine. Objectives Nussbaumer-Streit et al. [1] conducted a rapid review on whether and how effectively quarantine prevents transmission of and mortality caused by COVID-19, and whether quarantine was more effective when combined with other measures (such as closing schools). This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. COCHRANE CORNER