Introduction
Healing to gain health is both an art and a science. The balance is delicately poised and the players involved are multi. Exploring them has become mandatory in order to find a lasting solution. Thus, all involved in providing health care should master the art of identifying them so that a satisfying and lasting solution is rendered.
Concept
In the truest sense, no disease entity has a single cause. So, the appetite for diverse conditions embedded in the causation of a health issue is not satisfied by a single one-line diagnosis. Therefore, different prototypes are floated to address this complex issue. One such is the ‘PRECEDE and PROCEED’ model which has gathered wider acceptance1, 2, 3, 4 Others in use to solve different health issues are General Program Planning Model, The rational planning model, Program Theory, Planning, and Evaluation Cycle.4 The sine qua non to all these is identifying the health issue, analysing it from its different perspectives, and finding viable solutions.5
A systematic way to carry forward this exercise starts with ‘Social Diagnosis’. Here, one tries to carry out sociological investigations so as to recognize the intricate interplay of factors between social structures that leads to manifestations of illnesses.6 Mostly, attention is drawn to basic social factors in terms of different social determinants of the disease termed as ‘distant risks’ rather than individualized risk factors call as ‘proximate risks’.6, 7 Thus, a valiant effort is put to unearth what plucks people’ ‘at risk of risks’. This in the long run benefits medical professionals, the general public, social scientists, and policymakers in particular, and society at large in general.8, 9
The next line of focus is on the ‘epidemiological diagnosis’. What ‘clinical diagnosis’ is to a patient; the ‘epidemiological diagnosis’ is to the community that includes the patient. Thus, individual patient care is a subset of the mother set i.e., community health care. In epidemiological diagnosis, both the medical and non-medical factors are investigated by epidemiological investigations, and their impact on human health is ascertained.10, 11 An understanding of these causal factors and collective ameliorative action by all stakeholders will ensure a favorable dwelling with a positive health impact on the dwellers.
Educational and ecological Diagnosis is the next step that should follow epidemiological diagnosis. Where in epidemiological diagnosis different behavioural, environmental, and genetic factors are explored, in educational and ecological diagnosis the point of contention is rousing healthy behaviour through scientific handling of predisposing, reinforcing, and enabling factors.11
The well-known predisposing factors that shape the tone for a desired behaviour are individual and societal knowledge, beliefs, attitudes, skills, and personal preferences. Once the necessary changes are undertaken to form the desired behaviour, its’ sustenance is ensured by employing necessary reinforcing factors. These can be in-form of different rewards and incentives or the implementation of Legislatorial provisions. The example may be positive changes in social support, social norms, or in terms of economic rewards.12, 13 The last and most difficult step in this diagnostic paradigm is maintaining the changed behaviour by ensuring the existence of necessary enabling Factors. These are done through the realization of different environmental policies. A robust and lasting policy is considerate of ethics, ethnicity, equity, economic viability, and strong political and societal will.12
The administrative and policy diagnosis stage is the last. Current organizational policies, resources, and situations that may impede or aid the growth of the health program are considered here.14, 15
All clinical diagnoses must be enriched with a greater understanding of different underlying factors of a disease or a health issue. Present-day doctors and healthcare providers should bear this in mind at the time of drafting the final management plan.
In conclusion, it should be underlined that in a "one world, one health" scenario, it is essential that all stakeholders are aware of various elements and bear them in mind before drafting a final management plan for a health issue.
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