ANTENATAL CARE MANAGEMENT SYSTEM

CASE STUDY: PEARL MEDICAL CENTER

BY

SULEIMAN ABDUL

209-063011-01931

Email: designerabdul@gmail.com

DEPARTMENT OF COMPUTER SCIENCE AND INFORMATION

TECHNOLOGY

FACULTY OF SCIENCE

A Project Report Submitted To the Faculty of Science for the Study Leading To a Project

In Partial Fulfillment of the Requirement for the Award of the Degree Of

Information Technology of Islamic University in Uganda

Supervisor

Mr. CHEMISTO MUSA

Faculty of science, Islamic University in Uganda

July, 2011

DECLARATION

I Suleiman Abdul Reg.no – 209-063011-01931, hereby declare that the contents of this report are

a true account and reflection of my experience during my Project development “Antenatal Care

Management System” A case study of (Pearl Medical Center, Kansanga).

Signed ……………………………… Date ………………………….

Suleiman Abdul

Department of Computer Science and IT

Faculty of Science

Islamic University in Uganda

i

APPROVAL

This Project report has been written and compiled under my supervision and is now ready for

submission to the faculty of Science in the department of Computer Science with approval.

.......................................................

Mr. Chemisto Musa

SUPERVISOR

Date …………………………..

ii

DEDICATION

I dedicate this report to my Parents, and my family at large plus all relatives and friends without

their Patience, understanding, support, and most of all their love and prayers, the completion of

this work would not have been possible.

iii

ACKNOWLEDGEMENT

Special thanks goes to Mr. Ntambi Musa (Senior Administrator), Pearl Medical Center, first and

foremost for granting my research approval to have it in the Medical center, my helpful

supervisor Mrs. Sauba for the well information helped out in most of the section in the study and

support that he gave truly helped in the progression and smoothness of the Project. The co-

operation is much indeed appreciated.

Great deals appreciations go to the contribution of my faculty - Faculty of Science (Islamic

university in Uganda) spear headed by Mr. Umar Yahya the faculty coordinator, I would also

like to thank all the staff at large (my university’s) patience in helping us complete this program.

Not to forget Mr. Chemisto Musa (My supervisor) for the smoothness, advices, motivations and

co-operation during the Supervision.

Last but not least I would like to thank my friends especially those who helped me out where I

was weak, Mr. Walusimbi Hakim, Mr. Bukenya Gadafi to mention but a few, for the wise ideas

throughout the Project.

Special thanks also goes to Mr. Abdul Maghied – my sweet father for all he has done with the

start since I started to crawl in education perspective and everything He has really done just

because of Me, Mrs. Saida Shaban – my mother and the only inspiration I have, for the great job

and encouragement always in my studies, Mr.Shaban Abditam, Waswa Hassan – my big

brothers, for the guidance, financial assistance and motivation they always and gave me through

the project, Miss Nakimuli, my brothers Kakooza Ali, Sseruja Hassan, Kamada Jingo, Taban

Anis plus sisters Fatuma Abdul, Rehema Abdul, Khasfa Abdul, Mama Ram, Mariam Nabatanzi,

Shilla Namudu , Nakawesa Ruth , My Aunties – Aunt Jowe, Aunt Mariam, Aunt Dania plus

Uncles – Uncle Juma and uncle Hassan for all they have done am really appreciative.

May Allah Bestow His Blessings on All of Us

iv

ABSTRACT

Maternity mortality has shown a steady decline in recent years but a marked socioeconomic

gradient persists. Antenatal care is generally thought to be an effective method of improving

pregnancy outcomes, but the effectiveness of specific antenatal care programmes as a means of

reducing Maternity mortality in socio-economically disadvantaged and vulnerable groups of

women has not been rigorously evaluated.

This proposed Antenatal Care Management system is designed to cater for the activities on

which are done during the Antenatal Care Processes at Pearl Medical Center’s Antenatal Care on

which includes the registration of the expectant mothers, following up the Antenatal Card, follow

ups of checkups of the mothers, following up the progress of the expectant mothers in the

hospital, plus drugs availability in the hospital in line with Antenatal Care and reporting the

situation of such expectant mothers registered in the hospital, balancing the payment of the

services in line with Antenatal Care management before discharge.

v

TABLE OF CONTENTS

DECLARATION............................................................................................................................I

APPROVAL..................................................................................................................................II

DEDICATION.............................................................................................................................III

ACKNOWLEDGEMENT..........................................................................................................IV

ABSTRACT...................................................................................................................................V

LIST OF FIGURES....................................................................................................................IX

LIST OF TABLES......................................................................................................................IX

CHAPTER ONE............................................................................................................................1

1.0 Introduction..................................................................................................................................................1

1.1 Background...................................................................................................................................................1

1.2 Statement of the Problem........................................................................................................................2

1.3 Objective of the Study...............................................................................................................................2

1.3.1 Specific Objectives of the Study............................................................................................................2

1.4 Scope of the Study......................................................................................................................................2

1.5 Significance....................................................................................................................................................3

CHAPTER TWO...........................................................................................................................4

LITERATURE REVIEW.............................................................................................................4

2.0 Introduction..................................................................................................................................................4

2.1 Web based Information Systems..........................................................................................................6

2.2 Databases........................................................................................................................................................6

2.3 Information Management.......................................................................................................................7

vi

CHAPTER THREE.......................................................................................................................8

METHODOLOGY.................................................................................................................................................8

3.0 System Study and Investigation............................................................................................................8

3.0.1 Interviews.......................................................................................................................................................8

3.0.2 Document Review.......................................................................................................................................8

3.0.3 Observation...................................................................................................................................................9

3.1.0 Requirement Specifications....................................................................................................................9

3.1.1 User Requirements.....................................................................................................................................9

3.1.2 Functional Requirements........................................................................................................................9

3.2.0 System Requirements..............................................................................................................................10

3.2.1 Software requirements...........................................................................................................................10

3.2.2 Hardware Specifications........................................................................................................................10

3.3.0 System Design.............................................................................................................................................10

3.3.1 Conceptual Design....................................................................................................................................11

CHAPTER FOUR.......................................................................................................................13

IMPLEMENTATION, TESTING AND EVALUATION........................................................13

4.0 Implementation..........................................................................................................................................13

4.0.1 Direct Implementation............................................................................................................................13

4.0.2 Parallel Implementation.........................................................................................................................13

4.1.0 Coding and Debugging the System....................................................................................................13

4.2.0 System Testing...........................................................................................................................................13

4.2.1 Results from Different Tests.................................................................................................................15

4.3 Logical Design............................................................................................................................................15

4.3.1 Data Flow Diagrams................................................................................................................................16

4.3.2 Entity Relationship Diagrams.............................................................................................................18

vii

4.4 Physical Design..........................................................................................................................................19

4.5.0 Getting Started with Antenatal Care Management System....................................................25

4.5.1 The Start up of the System....................................................................................................................25

4.5.2 System Interfaces......................................................................................................................................26

CHAPTER FIVE.........................................................................................................................31

DISCUSSION, CONCLUSION AND RECOMMENDATION..............................................31

5.0 Introduction................................................................................................................................................31

5.1 Discussion.....................................................................................................................................................31

5.2 Limitations...................................................................................................................................................31

5.3 Problems Encountered...........................................................................................................................32

5.4 Recommendations.....................................................................................................................................33

5.4 Conclusion....................................................................................................................................................34

REFERENCES............................................................................................................................35

APPENDICES:............................................................................................................................36

Interview Guide.....................................................................................................................................................36

viii

LIST OF FIGURES

FIGURE 1: LOGIN FORM SCREEN...................................................................................................26

FIGURE 2: MAIN FORM SCREEN....................................................................................................26

FIGURE 3: PROGRESS FORM..........................................................................................................27

FIGURE 4: ANTENATAL CARD FORM............................................................................................28

FIGURE 5: ISSUING DRUG..............................................................................................................28

FIGURE 6: PREVIOUS OBSTERIC....................................................................................................29

FIGURE 7: DRUGS..........................................................................................................................29

Figure 8: User management........................................................................................................30

LIST OF TABLES

TABLE 1: SHOWING CONCEPTUAL DESIGN..................................................................................11

TABLE 2: SHOWING SYMBOLS AND MEANINGS USED IN THE DATA FLOW DIAGRAM;..................17

TABLE 3: SHOWING USERS TABLE;..............................................................................................19

TABLE 4: SHOWING ANTENATAL CARD TABLE;..........................................................................20

TABLE 5: SHOWING ANTENATAL PROGRESS;..............................................................................20

TABLE 6: SHOWING WARD;..........................................................................................................21

TABLE 7: SHOWING BED ASSIGNMENT;........................................................................................21

TABLE 8: SHOWING PREVIOUS ILLNESS TABLE;..........................................................................22

TABLE 9: SHOWING PRESENT PREGNANCY;................................................................................22

TABLE 10: DRUGS TABLE...............................................................................................................22

TABLE 11: SHOWING PHYSICAL EXAMINATION;...........................................................................23

TABLE 12: SHOWING OBSTERIC TABLE;........................................................................................23

TABLE 13: DRUG _ STOCK.............................................................................................................24

TABLE 14: ISSUED_DRUGS.............................................................................................................24

TABLE 15: PRESENT PREGNANCY..................................................................................................24

Table 16: Physical_ exam............................................................................................................25

ix

CHAPTER ONE

1.0 Introduction

This chapter consists of background for the study, problem statement, the purpose of the

Study, objectives of the study, scope of the study plus significances of the study.

1.1 Background

With the current upgraded technologies involving information management based solutions

in many organizations in Uganda and other different countries rather than the backward

systems like the file based systems that consisted of huge work load and miss use of space

plus their none cost effectiveness, it has become a concern for the information technologists

to digitalize solutions that can be used in such environments thus designing and

implementing the digitalized systems to suit the changing technological environment.

In that line therefore an Antenatal management system will be such of the digital solutions

that will be used to digitalize activities that are usually done at Hospitals in most issues

concerning the monitoring and managing the health of expecting mothers till their delivery

in good condition.

Owing to the above, the idea of an Antenatal management system is as a result to observing

the Antenatal care Management and other activities done in that line in Hospitals, health

centre’s and the levels of distribution and rendering of services to clients in that perspective.

There are many medical centers today that still use the file based systems of information

management instead of the computerized system, including even most popular hospitals in

the country on which has lead to loss lots of time and information.

1

1.2 Statement of the Problem

With the clear review on the operations in Antenatal Care Management at Pearl Medical

Center, Kansanga, notice has been indorsed that there is difficulty in tracing health

performance of the expectant mothers and the delivered babies/ newly born babies. This is

merely seem to be because of the over dependence of file based system with most health

facilities in the country thus with such redundancy of the health concerning expectant

mothers leading to high number of maternity mortality in Uganda, all due to not having a

defined way of maintaining records in the Antenatal Care sections a result loss of trust to

such Hospitals. The other problem is the Paper over Load which of course creates a lot of

redundancy in the records hence wasting Space and time. Therefore an Antenatal Care

Management system will cut down paper loads, trace payments, offer recommendations per

the situation, and lastly prepare expectant mothers for safe birth delivery. Hence efficiency,

quality of service will be optimized in line with Antenatal care management in the hospital

once the system is put in use.

1.3 Objective of the Study

To develop a functioning Antenatal Care Management System.

1.3.1 Specific Objectives of the Study

i) Identify the requirements to develop an Antenatal Care Management System digital

solution.

ii) To design a computerized solution stand alone technologies for Hospital with such facilities.

iii) Implementing and testing the computerized solution.

1.4 Scope of the Study

The project focused mainly on the main operations that take place in the Hospitals in line

with Antenatal Care or preparations made for a mother’s prepare for healthy delivery, like

treatments of the victims before and after delivering, and operations like billing of the

patients, tracking of the patients Record and scheduling of the Patients appointments etc.

This research will hopefully be carried out at Pearl Medical Center, Kansanga.

2

1.5 Significance

With the success of the research, it will be of significance to the Organization, the

Researcher and the University in the following ways;

i. The organization shall be able to boost their services and analyze their performance in line

with preparation of Antenatal Care plus other operation to give hand in fulfilling safe

delivery since the system will cater for problems in that line.

ii. The study will help the researcher to fulfill the requirement for the award of bachelor’s in

information technology, plus mastering the theory basics attained in all the persuasion of the

bachelor’s degree in the university.

iii.The project can also be referred to by other scholars for academic reference and even for

further research.

3

CHAPTER TWO

LITERATURE REVIEW

2.0 Introduction

This chapter hints on what different authors have written about Antenatal Care Management

systems, its limitations and effects to users in comparison with the benefits associated with

its implementation as a solution. And it also involves a review of previous studies in relation

to the research topic of analyzing, developing and implementing Antenatal Care Management

system.

Every human being on the planet is concerned with the process of birth. It is a sign of new

Beginning and growth and perception of soul (atma) or god. But the process is painful and

consists of Tapa sadhana (patience and perseverance) for almost a year and nursing and

upbringing for couple of years ahead. Hence every science, tradition, therapy has tried to

make the process safe, less painful, and successful. The management of physiology,

psychology with medicinal and non-medicinal ways to achieve healthy mother and fetus is

called as Antenatal or prenatal care.

Antenatal Care (ANC) means “care before birth”, and includes education, counseling,

creening and treatment to monitor and to promote the well-being of the mother and foetus.

The current challenge is to find out which type of care and in what quantity is considered

sufficient to ensure good quality of care for low-risk pregnant women. Only interventions of

proven effectiveness, for which benefits largely overcome possible harms, and those

acceptable to pregnant women and their families, should be offered. Crowther CA. Anti-D

administration in pregnancy.

The aim of Antenatal care (ANC) is to assist women to remain healthy, finding and

correcting adverse conditions when present, and thus aid the health of the unborn. ANC

should also provide support and guidance to the woman and her partner or family, to help

them in their transition to parenthood.

4

This implies that both health care and health education are required from health services.

This broad definition of ANC is endorsed by national labour laws and by evidence-based

clinical guideline. Moreover, it introduces the needed holistic approach (biological care and

concern with intellectual, emotional, social and cultural needs of women, babies and

families) during pregnancy.

Care during pregnancy should enable a woman to make informed decisions, based on her

needs, after discussing matters fully with the professionals involved. Any interventions

offered in the antenatal period should be of proven effectiveness and be acceptable to the

recipients. Both the individual components and the full package of ANC should conform to

these criteria. (PEPC Essential antenatal, prenatal and postpartum care. Training modules.

Copenhagen:WHO Regional Office for Europe, 2002 accessed 29 September 2005).

Recently, Antenatal care, like other health care subsectors, has undergone major changes, one

of these being the willingness to ‘‘integrate’’ the different services offered in the health care

system. ‘‘Integrated care’’ has been a very popular organizational trend since the 1990s. One

of the keys to its popularity has been the expectations it has raised, particularly in terms of

improvements in quality of care and efficiency. Shortell SM, Gillies RR,(1996).

With Rutecki GW. (2010). Prenatal care (also known as antenatal care) refers to the medical

and nursing care recommended for women before and during pregnancy. The aim of good

prenatal care is to detect any potential problems early, to prevent them if possible (through

recommendations on adequate nutrition, exercise, vitamin intake etc.), and to direct the

woman to appropriate specialists, hospitals, etc. if necessary. The availability of routine

prenatal care has played a part in reducing maternal death rates and miscarriages as well as

birth defects, low birth weight, and other preventable infant problems. Animal studies

indicate that mothers' (and possibly fathers') diet, vitamin intake, and glucose levels prior to

ovulation and conception have long-term effects on fetal growth and adolescent and adult

disease.

5

Coppens M, James D (1999) Focus of antenatal care in developed countries has expanded

from its traditional aim of preventing, detecting and managing problems and factors which

might adversely affect the health of mother and/or baby. It now includes broad aims such as

"to support and encourage a family's healthy psychological adjustment to childbearing", and

"to promote an awareness of the sociological aspects of childbearing and the influences that

these might have on the family". This broader approach echoes the development of 'quality of

life'-focused assessments in the wider field of health care.

2.1 Web based Information Systems

Larry, 2003 Asserts that web based information systems provide up-to-date product and

support information to existing and emerging channels. A prerequisite of this is to support

the process of creating all these types of information once only, managing and making them

available on a timely and cost effective way for all people in the information chain.

2.2 Databases

According to Lane and William (2004), a database is part of data management system. They

define a database as a container of data files, such as product catalogs, inventories and

item/customer records. They say that every business would be a failure without a secure and

reliable data management system. They further say that information systems are the hearts of

most businesses worldwide. According to them, it is not easy to have a secure system, but a

system developer must ensure that this is achieved. They advise system developers to have

clear subject areas, requirements and plans before they start designing the systems.

Braker and Hellerstein (1998), say that database has experienced a rapid increase in growth

since the development of a rational data base. The progress in database systems and

applications has produced a large scope of specialized technology areas that have often

become the exclusive domain of research specialists. Examples include active database,

object oriented, temporary database, and deductive database areas. Advanced database

systems were written by leading specialists who have made significant contributions to the

development of technology areas.

6

Siau (2003) asserts that many databases that we find on the web today are derived from other

databases. New databases are often created because there is a need for customized data and

often, the databases are created with new data added in the process. In this situation, a

system that is able to carry along superimposed information or annotation about the data is

useful in many aspects. Siau (2003) envisions an annotation management system that is not

only capable of carrying forward annotation of data being transformed, but that is also

capable of attaching new comments on derived data, back to the source data.

With French (1992), it’s also a single collection of structured data stored with a minimum

duplication of data item so as to provide a consistent and controlled pool of data. This is

common to all user systems, but is independent of the programs that use data. The

independence database and programs using it means that one can be changed without

changing the other. The user of database may find it convenient to imagine that they are

using integrated system.

According to Thierry (2006), the term database design can be used to describe many

different parts of design of an overall system. Principally, and most correctly, it can be

thought as the logical design of the database of database structure used to store data in are

rational model these are the tables and views. However the database design could be sued to

apply overall process of designing, and not just base data structures, but also forms and

queries are used apart overall database application within database management system

(DBMS).

2.3 Information Management

Data can be defined as individual facts or raw about something that can be organized to

generate useful information for decision-making. Information is stimuli that have meaning in

some context for its receiver. When data is entered into and stored in a computer, it is

generally referred to as information.

Graham (2001) said, with the move from local application to a web based ones, also the ata

we created and access will need to undergo some profound changes. Data and information

undergoes a management process to maintain its consistence and quality. Physical and

logical security, quality assurance is emphasized to ensure rational utilization and reliability

of data/information.

7

CHAPTER THREE

METHODOLOGY

3.0 System Study and Investigation

The chapter involved a critical study of the existing management systems at Pearl Medical

Center. This chapter introduces the methodology and techniques that were used in acquiring

and analyzing information and to achieve the objectives of the project. It therefore includes

the methods, technique, design tools, approaches and procedures which were adopted to

collect and analyze information. The methods that were used include interviews, document

analysis, and observation.

3.0.1 Interviews

This method was used to collect information from Pearl Medical Center administrators as the

researcher was asking questions about the current system. Interviews were conducted with

Dr. Umar Kasule one of the Doctors of Pearl Medical Center and a Senior administrator, Mrs

Saubah the midwife and Warden plus Mrs. Halimah the receptionist. During the interviews,

these individuals described the process they involved and problems faced in administering

the current Antenatal Care System and from the interviews with other staff members plus

some expectant mothers, the researcher was able to identify the problems faced and the user

requirements for the proposed system.

Reasons for using such a method;

To obtain detailed information Personal perception opinions.

To spell out ambiguities and a fall up of incomplete answers.

3.0.2 Document Review

With this method, the researcher reviewed market documents which included Patients’

register, receipt books, vouchers. This method helped the researcher to obtain various

information captured for different events and it was a supplement to the information from the

interviews made at Pearl Medical Center.

8

3.0.3 Observation

Observations were carried out accompanied by visits to the medical center where the

research was carried out, participants and their daily conduct of activities, events and their

sequence and attendant processes. In this line this kind of method helped the researcher to

gain a clear flow of the activities involved and how they were conducted.

3.1.0 Requirement Specifications

Requirements specifications involve what the system should do. Therefore it provides

detailed documentations of requirements and these are categorized into collection and

analysis of user requirements, functional requirements and systems requirements.

3.1.1 User Requirements

In this line it comprised of the preferred features by the user in the system on which from the

interviews and comments from the medical center’s staff and users to be using the system it

was revealed that the system should be able to;

Provide user friendly interfaces for easy interactions.

Allow users to enter data easily from the interface and is saved to the database.

Print the necessary reports with the most accurate information.

Restrict unauthorized login attempts to the system.

3.1.2 Functional Requirements

This outlines how the system serves the users by ensuring efficient and effective

functionality. The system therefore is able to:

Allow registration of expectant Mothers willing to have Antenatal Care Services of

Pearl medical Center

To enable the administrators to effectively track Expectant mothers Progress.

To allow easy track Payments of Antenatal Care.

To provide adequate reports

9

3.2.0 System Requirements

These are requirements that were needed to incorporate the desired functionalities in the

system. This therefore called for the description of the properties of the system and this had

to address both the software and hardware requirements.

3.2.1 Software requirements

For the success of the system’s objectives, it was a combination several software’s on which

worked hand in hand to execute per the expectation of the study on which they included the

following;

Windows 7 ultimate 32 bit operating software was used for efficient running of the

system.

Microsoft Visual studio using C# language was selected and used for code generation

and interface designs.

MySQL database software was used for database designs to store the data entries

from the interface.

3.2.2 Hardware Specifications

Due to the need of reach to the expected efficiency of the system per the study the following

Hardware specification were considered;

The system can run efficiently on a computer with at least 1.2 Ghz Processor Speed,

free space of 500Mb, with at least 512Gb of RAM.

3.3.0 System Design

It refers to the art of defining the architecture, components, modules, interfaces, and data for

the system to fulfill the project main objective.

The main goal of the design phase is to find the best possible design, within the limitations

imposed by the requirement and the physical as well as social environment in which the

system will operate.

10

3.3.1 Conceptual Design

Conceptual design refers to the explicit construction of the idea or concepts that a user needs

to learn about what a product is, what it can do, and how it is intended to be used. This

involved various entities and attributes identification on which can be seen as follows;

Table 1: Showing Conceptual Design

Entity Attributes

Users - Full Name

- User Name (pk)

- Password

- Role

Antenatal card - RegNo - LCI

- HealthUnit - Occupation

- Name - Religion

- Age - Education

- Tribe - Status

- Next_of_kin - Relashinship

- N_occupation - Address

- Gravida - Para

- Abortion

Antenatal Progress - ID - RelationPP_Brim

- Reg_no - FoetalHeart

- Amenorrhea - Weight

- FundaHeight - BP

- Presentation - varicose

- Position - urine

Ward - Bed_id

- Location

- Status

- Description

Drugs - Drug_No

- Name

11

- Description

- Rate

DrugStock - Stockid

- StockDate

- Drugid

- Quantity

- Rate

- Amount

- StockBy

Physical examination - Id

- Reg_no

- Height

- Weight

- BP

- Pulse

- Temp

- Pelvic examination

Issued Drugs - Issue id

- Issue_date

- Drug_id

- Quantity

- Rate

- Cost

- Sale by

Present pregnancy - Id

- Reg_no

- LNMP_day

- EDD

- GEstationPeriod

- Complications

- Curr_symptom

12

CHAPTER FOUR

IMPLEMENTATION, TESTING AND EVALUATION

4.0 Implementation

There are mainly two forms of new systems implementation on which comprises of the direct

form of implementation and the parallel one.

4.0.1 Direct Implementation

Under this form of implementation there is a direct cut over of the old system while the new

system takes its course. In direct implementation, the users stop using the manual system and

start using the computer system there and then. The lead of this method is that it doesn’t need

more man power hence making it less costly, however on its depressing point of view if the

new system fails to operate effectively either due to an expected error this can lead to loss of

data since it was implemented. I therefore don’t recommend serious organization that deals

with serious information to use this method of system implementation.

4.0.2 Parallel Implementation

In this line, a new system is implemented alongside an old system, this implies both the new

and the old system will be running simultaneously until when the new system proves its

integrity over the old one. Due to advantages the parallel implementation method has over

the direct cut over the parallel implementation method is recommended.

4.1.0 Coding and Debugging the System

Coding and debugging the system may be in straightforward stipulations referred to as

programming. In this line concerning the study at hand Antenatal Care Management System

For Pearl Medical Centre, the researcher used visual basics (Microsoft visual studio Ultimate

2010) and Mysql database systems.

4.2.0 System Testing

System testing is a critical aspect of Software Quality Assurance and represents the ultimate

review of specification, design and coding. Testing is a process of executing a program with

the intent of finding an error. A good test is one that has a probability of finding an as yet

13

undiscovered error. The purpose of testing is to identify and correct bugs in the developed

system. Nothing is complete without testing. Testing is the vital to the success of the system.

In the code testing the logic of the developed system is tested. For this every module of the

program is executed to find an error. To perform specification test, the examination of the

specifications stating what the program should do and how it should perform under various

conditions.

Unit testing focuses first on the modules in the proposed system to locate errors. This enables

to detect errors in the coding and logic that are contained within that module alone. Those

resulting from the interaction between modules are initially avoided. In unit testing step each

module has to be checked separately.

System testing does not test the software as a whole, but rather than integration of each

module in the system. The primary concern is the compatibility of individual modules. One

has to find areas where modules have been designed with different specifications of data

lengths, type and data element name.

Testing and validation are the most important steps after the implementation of the developed

system. The system testing is performed to ensure that there are no errors in the implemented

system. The software must be executed several times in order to find out the errors in the

different modules of the system.

Validation refers to the process of using the new software for the developed system in a live

environment i.e., new software inside the organization, in order to find out the errors. The

validation phase reveals the failures and the bugs in the developed system. It will be come to

know about the practical difficulties the system faces when operated in the true environment.

By testing the code of the implemented software, the logic of the program can be examined.

A specification test is conducted to check whether the specifications stating the program are

performing under various conditions. Apart from these tests, there are some special tests

conducted which are given below:

14

Peak Load Tests: This determines whether the new system will handle the volume of

activities when the system is at the peak of its processing demand. The test has revealed that

the new software for the agency is capable of handling the demands at the peak time.

Storage Testing: This determines the capacity of the new system to store transaction data on

a disk or on other files. The proposed software has the required storage space available,

because of the use of a number of hard disks.

Performance Time Testing: This test determines the length of the time used by the system to

process transaction data.

4.2.1 Results from Different Tests

In line with the code testing on which the logic of the developed system was tested it was

revealed that in the drug issue module on the system where after the recording of the Issue id

by a click to drug id the rates of the drug were supposed to appear per the quantity

automatically on which an error was found that one had to enter the rates manually on which

was later covered effectively.

Still on the system testing it was tried out to input in fields on which were supposed to be of

integers then put in characters for example in the payment module where the calculation of

amount paid for different services, it was tested whether it could accept character inputted

data on which was inacceptable thus showing validity of the system.

4.3 Logical Design

The logical design of the system consisted description of the conceptual presentation of data

flow, inputs and out puts of the system, this was conducted via modeling, involving

theoretical and graphical representation of an actual system’s design. On which the modeling

undertook the following;

15

4.3.1 Data Flow Diagrams

This refers to diagrammatic representation of information flow in the system between the

different entities and processes. Data flow Diagram shows how data moves through the

system but does not show program processing steps however, it provides a logical model that

shows what the system does. This diagram was used to exhibit the business processes, inputs

and outputs of each process, and the flow of data between the processes plus the data stores.

16

Symbol Meaning

Entity e.g. user, branch, suspects.

A data store.

Process

A data flow.

Table 2: Showing symbols and meanings used in the data flow diagram;

PEARL MEDICAL CENTER ANTENATAL CARE MANAGEMENT SYSTEM

17

Discharge Details

Patient

1 1

Record PatientProcessPatient

InfoPayments

2 2

3 3

4 4

5 5

Patient Records

Payment

CheckupProcess

Patient

Progress Details

Beds RecordAssign

Bed Process

Checkup

Patient D

etails

Pharmacy

Pharmacy Details

Drug Info

Treatment

Discharge ProcessDischarge Form

Discharge Payments

Checkup

Drug payments

4.3.2 Entity Relationship Diagrams

Entity relationship Diagram was the tools on which were used to show the relationship

between different entities that were involved in the system information flow. This tool helped

the researcher to identify the attributes of each entity and the cardinalities between the

relationships.

PEARL MEDICAL CENTER ANTENATAL CARE MANAGEMENT SYSTEM

ENTITY RELATIONSHIP DIAGRAM

18

Receptionist

Patient

Midwife

DoctorBed

Records

Treats

Monitors

Assigned

Pharmacy

Drug

Issues

Receives

User Name

Password

Role

Bed_id

Location

Description

Status

User_Name

Password

Role

Pat_id

Pat_Name

User_Name

Password

Role

Stock

Drug_id

Drug

Drug_NoName

Description

Rate

4.4 Physical Design

The physical design of a system is concerned the actual physical implementation of the

logical design as already discussed earlier. This section describes the actual processes of

inputting, verifying and storing the in Antenatal Care Management System, physical layout

of the data stores, report formats and relation database management system used. During the

physical design process, the researcher had to translate the expected schemas into actual

database structures mapping the, entities to tables, relationships to foreign key, attributes to

columns, primary unique identifiers to primary key constraints and unique identifiers to

unique key constraints with the help of Mysql Database Software on which was used for the

Data storage for the system.

The following were the different physical design;

Table 3: Showing Users table;

19

Table 4: Showing Antenatal Card table;

Table 5: showing Antenatal Progress;

20

Table 6: Showing ward;

Table 7: Showing bed assignment;

21

Table 8: Showing previous Illness Table;

Table 9: Showing Present Pregnancy;

Table 10: Drugs table

22

Table 11: Showing Physical Examination;

Table 12: Showing Obsteric table;

23

Table 13:Drug _ stock

Table 14: Issued_drugs

Table 15: Present pregnancy

24

Table 16:Physical_ exam

4.5.0 Getting Started with Antenatal Care Management System

After the systems final coding for the perfection of what is expected from it, it was turned

into an executable file which can enable it be installed on any machine without visual basic.

So as to help make the system perform its functionalities’ with just its installation on any

machine with the requirement per mentioned in Chapter III of the Report, all the installation

files are copied into one directory in the programme files and short cut icon is places on the

desktop.

4.5.1 The Start up of the System

The startup is simple as normal programs on which with just a double click on the short cut

“Antenatal Care Management System”, a screen will show up indicating the log on form on

which requires credentials to continue using the system.

Security of information is the first thing each manager will put into consideration, in any

system to be used by more than one person for example in an organization like a hospital,

companies and others that contain lots of important information. There for the researcher

came up with a login form that permits use of the system, on which none authorized users

can access the system. Only valid users with correct user name and password can log into the

system.

25

4.5.2 System Interfaces

Figure 1: Login Form Screen

The login form is presented with two text boxes and two command buttons as shown in the

figure above. Enter the correct user name and password in their respective text boxes and

then click the “OK” command button or else click “Cancel” command button on which will

cancel the login form and you cannot access the system.

Figure 2: Main Form Screen

26

The main form acts as a navigation point of all pages of the system, through the main form,

you can access any part of system depending on your level of authentication. Some legal

users will not access some forms that are not in their area of concern. Only the administrator

will be allowed to access everything in the system.

With the above figure it’s the main page on which every user goes to after the login, it

contains most of the features in the system for example different privileges per the user for

example editing users and other functionalities.

Figure 3: Progress Form

This is the form on which on which follows up the progress of the expectant mother in

accordance to the last visits on which if a patient has been performing checkups one can

such for the progress result depending on the patient number.

27

Figure 4: Antenatal Card Form

The above form is mainly used to enter the information of the expectant mother in different

perspectives, for example, the expectant mother’s biography, taking of their social history,

previous illness, and physical examination.

Figure 5: Issuing Drug

With this form it’s useful in a manner of tracking the issuing of drugs with information like

the type of drug, the staff that has sold the drug, the date issued plus their cost.

28

Figure 6: Previous Obsteric

The above figure indicates the ways on which the expectant mother had been affected

during delivery processes.

Figure 7: Drugs

With the above figure the system has the capability to register the drugs on which are to be

issued to the patients so, edit, provide description and keep track on the drugs availability.

29

Figure 8: User management

With this form, the system can add users, edit and delete any user but this was customized

for the administrator with such privileges.

30

CHAPTER FIVE

DISCUSSION, CONCLUSION AND RECOMMENDATION

5.0 Introduction

This chapter gives a summary of the entire system with emphases on its achievements and

limitations. There are also suggestions on possible areas of enhancement.

5.1 Discussion

The system was designed to fulfill the basic aim and specific objectives that were proposed at

the earlier stage of the system development. A system comprises of people, equipment, space

and procedures. The researcher was mindful of the input, processing, storing and retrieving

requirements necessary for an effective system. The main users to interact with the system

are the Doctor, Hospitals Administrator, Receptionist, Midwife, and the warden.

In any software development, security is always a very important issue for consideration. The

administrators should therefore make use of authorized persons to take charge of the system.

It is thus management obligation to ensure internal controls and security about the system,

the system cannot be accessed by any user except the authorized user with the login ID and

password.

5.2 Limitations

It is not usually possible to design a system that meets the needs of every user, therefore the

system has the following limitations;

There are fixed queries that have been designed by the researcher. This means that the users

cannot run queries of their choice unless the system is upgraded.

Project was quite limited since the project entails some components that required to be

delivered on time with full functionality

Biased responses from some of the interviewees.

Lack of interest from some of the would-be users of the new system due to fear of loss of

jobs as a result of the automation that the new system inhibits.

31

5.3 Problems Encountered

There are as many problems encountered as a system is one of the tasks on which needs

much of attention, thus the following problems were encountered during the development

process of coming up with the System;

One of the biggest problem encountered on which it’s more so a general problem per all

students that were carrying out project at Islamic University Kampala Campus was

limitation in time to enable development of a program with better features. On which we

were first given some desirable deadline at fast that was handing in over early

September and on which was abruptly changed to a nearby date thus leading to

compression of functionalities that would be included in the system due to limited time.

The researcher also encountered a problem of getting a case study as most issues

concerning health are confidential, and had to move to different hospitals after being let

down by the last medical hospital I had gone for information not until found Pearl

Medical Center after a lot of struggle and was too late thus leading to panic and

reducing on the scope of the project system

In accessibility to the most current literature on soft ware development Despite the

normal programming procedures followed, some segments could not run normally

especially in the viewing forms, may be due to computer memory problem since Visual

Basic takes allot of memory.

Another encountered problem was limited access to better resources that were used in

developing the system, specifically designing software’s like Edrawer, Ud on which

internet access was always on and off thus even though they were downloaded the best

that could be got were trial versions on which worked for 15 – 30 days hence

disorganizing the researchers plans to come up with more unique and high performance

system.

The other encountered problem was on research or requirements engineering on which

needed a lot of information from the medical center on which the research place was

always Busy thus limited attention was given to the researcher since it was a big

32

medical center they worked 24 hrs a day leading to getting most requirements from

observation and the least through one on one interviews.

Lack of proper documentation about the existing system was another problem

encountered on which was a big bottleneck for System development.

During data collection process, the staff was reluctant to release any information, as it

was even hard for the researcher to be given sample forms that were used to be used in

Antenatal Care Services with the fear that they might be supporting a competitor.

5.4 Recommendations

First of all, it’s important that Pearl Medical Center continues to use the old manual system

alongside per speculations in the implementation section in the report as the Medical Centre

has many clients and the system users have to be trained to use the system as they may lose

information on which may be of great use in the Hospital, thus the users should first use the

manual and the automated system parallel till knowledge that the automated system is worth

their expectations.

Similarly as mentioned above, the users need to be trained on how best they can use the new

automated system. Users with basic computer skills will be required in order for them to

appreciate the functionality of the program.

The system has a lot of room for further improvement though as it stands it can be used as a

prototype to develop an Antenatal Care Management System and more features could be

added, since less time was available for the researcher.

Lastly on the recommendation as hinted before in supplements of the recommendations about

the limited time, the report is not containing all that is in the Project system as it was still

under construction and the due to need of beating the deadline of Report handing in most of

the Parts needed were included in the Report Living out little bits on which were under

construction and changes will be made after the completion of the system by 26th of July.

33

5.4 Conclusion

Computer-based Antenatal Care Management System functions are becoming an essential

technology for health care in part because the information management challenges faced by

health care professionals are increasing daily. Technological progress makes it possible for

Antenatal care Management systems to provide total, cost-effective access to more complete,

accurate patient care data and to offer improved performance and enhanced functions that

can be used to meet those information management challenges. Antenatal Care Management

System can play an important role in improving the quality of expectant Mothers Antenatal

care they can also contribute to the management and moderation of health care costs.

The Institute of Medicine (IOM) study committee believes that the time is right for a major

initiative to make standard technology in health care within a decade. Achieving this goal

within 10 years will require a nationwide effort and a great deal of work. More research and

development are needed in several critical areas to ensure that systems meet the needs of

patients, practitioners, administrators, third-party payers, researchers, and policymakers. For

example, the need to protect patient privacy must be balanced by the need for timely access

to data at multiple sites. Systems must offer both considerable flexibility for users and

standards required for data transfer and exchange.

34

REFERENCES

1. Braker, Stone M & J.M Hellerstein (eds.) (1998). ”Reading in databases”. Kaufmann San

Francisco

2. Hallmark, J; Garcia, C (1992). System migration experiences from the field. Information

Technology & libraries, 11 (4), 345-358.

3. Hudgins, J; and Macklin, L. (2000). New materials, new processes: implementing digital

imaging projects into existing work flow. Library collections, Acquisitions, &Technical

services, 24(2), 189-204.

4. Laudon. Kand Laudon J (2002) management information systems, 7th Edition, Pearson

Education Asia

5. Lewis. C. and Griffin M. (1997),, Human factors consideration in clinical applications of

virtual reality.

6. Riva. G., (1999), Virtual Reality as a communication tool: a socio-cognitive analysis

Teleoperators, and Virtual Environments

7. Siau, Keng (2003). Advanced topics in database research, volume 5

8. Shortell SM, Gillies RR, Anderson DA, Erickson KM, Mitchell JB. Remaking health

care in America. San Francisco:

9. Yaspan, Arthur (1961). Operation Research. Vol 9, pp. 371-38

35

APPENDICES:

Interview Guide

Questions

1. What are the strength of the current system on which the Medical center is using in line

with the management of Antenatal Care?

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

…………………………….

2. What are its weaknesses in details?

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

3. What are the limitations of the current system used in the medical center per Antenatal

Care Management?

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

36

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

4. What are the problems faced by the current system?

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

…………………………….

5. How would you want the new system to work per its perfection?

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

37

6 What are the main features that you may want to be included in the new system?

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

7 Who is supposed to be given what privilege per the activities in the antenatal care in

details, for example who is supposed to fill the Antenatal Card, or who is Supposed to

record Payments?

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

Thank you

38