Primary health care and health care reform

Primary health care (PHC) is a philosophy or approach to health care whereby health is acknowledged as a fundamental right, as well as an individual and collective responsibility. This approach requires that health care addresses the causes of poor health, not only its symptoms. The focus is on care for the person, not simply treatment of her or his health condition. Most health care systems have been developed to respond to illness, rather than to create and support wellness. Affordable, sustainable health care appropriate to local need, ensuring social justice, equity, community participation and promoting health, is the goal of PHC. For this to be truly achieved, change in health care systems must occur

Gadamerian philosophical hermeneutics as a useful methodological framework for the Delphi technique

In this article we aim to demonstrate how Gadamerian philosophical hermeneutics may provide a sound methodological framework for researchers using the Delphi Technique (Delphi) in studies exploring health and well-being. Reporting of the use of Delphi in health and well-being research is increasing, but less attention has been given to covering its methodological underpinnings. In Delphi, a structured anonymous conversation between participants is facilitated, via an iterative survey process. Participants are specifically selected for their knowledge and experience with the topic of interest. The purpose of structuring conversation in this manner is to cultivate collective opinion and highlight areas of disagreement, using a process that minimizes the influence of group dynamics. The underlying premise is that the opinion of a collective is more useful than that of an individual. In designing our study into health literacy, Delphi aligned well with our research focus and would enable us to capture collective views. However, we were interested in the methodology that would inform our study. As researchers, we believe that methodology provides the framework and principles for a study and is integral to research integrity. In assessing the suitability of Delphi for our research purpose, we found little information about underpinning methodology. The absence of a universally recognized or consistent methodology associated with Delphi was highlighted through a scoping review we undertook to assist us in our methodological thinking. This led us to consider alternative methodologies, which might be congruent with the key principles of Delphi. We identified Gadamerian philosophical hermeneutics as a methodology that could provide a supportive framework and principles. We suggest that this methodology may be useful in health and well-being studies utilizing the Delphi method