Essential public health functions: results of the international Delphi study

The essential public health functions (EPHFs) approach is an integral component in the elaboration of the Health for all (HFA) policy in the 21st century and a necessary element for building sustainable health systems. An international Delphi study on EPHFs was conducted in 1997. This international study included a respondent group of 145 public health experts from all regions of the world. The core monitor group included the members of the WHO EPHFs working group, and 8 senior public health figures from both developing and developed countries. The primary objectives of this study were: to define the concept of EPHFs; to establish consensus on what functions constitute EPHFs, and to determine which public health functions are likely to be most essential in the future and to confirm which public health functions require the elaboration of performance standards. Three rounds of the study were completed in December 1997, and this paper provides an overall summary of the findings.