CHUKWUEMEKA ODUMEGWU OJUKWU UNIVERSITY

DEPARTMENT OF COMPUTER SCIENCE

FACULTY OF PHYSICAL SCIENCE

A PROJECT WORK ON

DESIGN AND IMPLEMENTATION OF AN ONLINE

ANTENATAL SYSTEM

SUBMITTED

BY

CHUKWUMA JOHNFREDRICK CHUKWUMA

2018 224 153

IN PARTIAL FUFILLMENT FOR THE AWARD OF

BACHELOR OF SCIENCE (B.SC) IN COMPUTER SCIENCE

SUPERVISOR: PROF. OGOCHUKWU OKEKE

JUNE 22
 ACKNOWLEDGEMENTS
First of all am dedicating this work to the Lord Almighty for giving me the ability to
complete this research work. I am grateful to this great citadel Chukwuemeka
Odumegwu Ojukwu University and Prof. O.C OKEKE Head of department
Computer Science for providing the necessary resource for the successful
completion of my work. A big thank you to my seminar supervisor Prof
Ogochukwu Okeke for her guidance and suggestion in the preparation of my
seminar work. Last but not the least a very big thank you to my parents for
sponsoring my academics to this point.
 ABSTRACT
The Antenatal Department of hospitals is for medical advice and treatments of
expectance mothers before delivery. Antenatal care is all about material and fetal
care, to see that the baby is developing without malformation and giving mothers’
advice on what to eat, type of exercise needed, scanning and pathology rest. This
Research is to design and implement a system (computerized) that offers
information on Antenatal care as of when due (Just-in-time), advise on what to
take and other medical guidance to pregnant mothers to effectively reduce
childbirth mortality and other related issues. The main aim of research is to replace
the existing manual Antenatal information system but with high reliability,
accuracy, speed and less cost.
 DEDICATION

I am dedicating this work to my parents (MR AND MRS MATTHEW IKWUMELU)

for their unconditional love, care, support and words of encouragement and also
to my siblings for their love.
 CHAPTER ONE

INTRODUCTION

1.1  Background To The Study

An information system provides information for decision makers in any organization, which are
required for the great functions of planning coordinating and controlling, therefore it is necessary
to discover an adequate means of making the information available to everyone concerned, this
is because for decision to be made correctly and timely the information must be consistent,
accurate and reliable (just-in-time) to affect the operation for which it is being provided. Thus,
this project work design and implementation of a computerized information system of Antenatal
care is aimed of provided necessary information about all operations. The antenatal unit which
are very necessary for proper control and coordination of the unit. An information system is
needed to provide basic data for any organization, which are required for decision making,
coordinating and controlling of records, therefore it is of great importance that the discovery of
an adequate means of making the information available to everyone concerned, this is because
for decision to be made efficiently and timely the information must be consistent, up-to-date,
accurate and reliable (just-in-time) to affect the operation for which it is being provided.
Pregnancy can be a stressful event for many women. Women experience stress during pregnancy
due to concerns about maternal-fetal safety, competence in the maternal role, physical changes,
anxiety of labor and birth, social relationships, and financial issues. Maternal age, parity,
pregnancy history, and maternal health status all could affect maternal stress perception. The first
and second trimesters have been reported as the most stressful periods for pregnant women, and
the stress in early pregnancy could last through late pregnancy month. A computerized Antenatal
education system has been shown to be an effective strategy for improving maternal stress and
self-efficacy during pregnancy, with the implementation of the Antenatal system, it will provide
opportunities for pregnant women to develop competence and obtain knowledge, skills, and
social support from health care providers. Researchers have suggested that antenatal education
should meet pregnant women’s needs by providing strategies to cope with common pregnancy-
related stressors. Pregnant women are interested in participating in a web based or internet-based
antenatal education or antenatal care. Previous research has reported that over 90% of pregnant
women are interested in using the internet or smartphones to search for pregnancy-related
information that affects their decision making. The current research aim is to design and
implement an effective computerized web-based antenatal education system on maternal stress
and other related health issues during pregnancy.

The Antenatal unit is an aspect of the outpatient department. The Antenatal unit is in charge of
carrying for material and fetal wellbeing before childbirth. This section of the hospital is facing
hitches presently due to the manual method of information processing.

Antenatal and postnatal care consist mostly of a series of screening tests of varied complexity,
implemented at different levels of care, which together contribute to evaluating the overall health
and nutritional status of each pregnant woman and newborn baby. Objective assessments of feta
land neonatal growth deviations can play a major role in routine clinical care, as well as maternal
and neonatal health research.

1.2   Statement of The Problem

1. Manual or traditional method of information processing.

2. Lack of adequate systems to track and keep records antenatal information of antenatal
patients.
3. Poor information retrieval process and loss of files.

1.3    Significance Of Study

A computerized antenatal system is greatly appreciated in maternity homes or health centers and
the antenatal/prenatal units in hospitals. This system would greatly enhance decision making of
doctors, nurses and mid wives concerning the antenatal care of a pregnant woman.

1.4    Scope Of The Study

This work only covers the functionality of the Antenatal system: Registration and Appointment
booking, record history of activities and stages of an antenatal patient. Storing and retrieving of
doctor’s reports.

The research work covers the importance of antenatal care.

1.5 Definition Of Terms

Amniocentesis:

This test is usually done around the 16th week of pregnancy. A needle is passed through the
mother’s abdomen into the uterus, under ultrasound guidance and a sample an amnesic fluid
surrounding the baby is withdrawn. The fluid contains substances from the baby, which can be
tested for certain conditions such as neural tube defects and cells which can be grown in culture.
The cells can be tested for down’s syndrome and other virosomal and inherited disorders.

Amniotic Fluid:

This is the fluid surrounding the fetus in the uterus which protects it during pregnancy and
labour. It contains substances and cells from the baby, which can be removed by amniocentesis
and examined.

Anomaly:

A malformation or abnormality in any part of the baby;

Chorionic Villus Test:

This test usually known as CVS (CV sampling) or CV Biopsy is a prenatal test which can be
performed early in pregnancy from 11 weeks. A sample of tissue that will form the placenta is
taken either through the cervix or the abdomen.
Chromosomes:

The thread like bodies found in all living cells which carry the genetic information. Normal
human cell contains 23 pair of chromosomes.

Chromosome Abnormality:

A change in the number or arrangement of the normal 23 pairs of chromosomes.

Combined Test:

Between 11 and 13 weeks of pregnancy, a combination of the nuchal sean measurement and a
blood sample from the mother which measures the concentration of two serums; pregnancy
associated plasma protein-A and frex Beta human chorionic gonadotrophin together with the
mother age are used to estimate her chances of having a pregnancy with downs syndrome.

Congenital Abnormality:

An abnormality presently at birth although not necessarily hereditary.

D & C (Diletation and Curreltage):

A procedure in which the cervix is gently opened and a loop shaped instrument is inserted to
scrap away the miner living of the uterus D&C (Dilatation and Evacuation) pregnancies can
sometimes be terminated under general anesthetic using this technique on which the cervix is
dilated and the uterine contents are removed by suction.

Down’s Syndrome:

A chromosome abnormality in which these are 3 copies of chromosomes 21 instead of 2. It is

also called trisomy 21. The condition is characterized by distinctive facial feature and varying
degrees of learning difficulties and is often associated with laying heart problems.
Edwards Syndrome:

A chromosome abnormality in which there are 3 copies of chromosome 18 instead of 2. it is also

called trisomy 18 the condition means that the baby may not survive pregnancy or may have a
short life and require specialized nursing.

ERPC:

Evacuation of the retained products of conception this is done following a spontaneous or

induced abortion. The placenta may be retained following a late termination and needs to be
removed surgically the phrase is felt to be rather callously.

False Negative:

Some women are told that tests have shown that their babies does not have a problem, only to
find out when the baby is born that there is not true this is call a false Negative and is not a
common occurrence.

False Positive:

This is the opposite of false negative.

Gene:

This unit of a chromosome is which particular characteristics are inherited from one or both
parents.

Genetic Abnormality:

A disorder arising from an abnormality in the chromosome which mayor may not be hereditary.

Genetic Counselling:

Advice and information provided by experts on the detection and chance of fetal abnormalities
and disorders.
Hereditary:

Characteristics transmitted through families, by genes within the chromosomes of the fertilized
egg and sperm.

Hydrocephalus:

This is due to an imbalance n the production and adsorption of cerebrospinal fluid(ISF) this
causes the ventricles in the brain to swell, causing pressure on the surrounding tissue.

Inherited:

Having a hereditary characteristic, this can be coloring a personality type or a disease.

Integrated Tests:

This integrated test is performed in two stages in the first stage, of around 12 weeks of pregnancy
and the second around 15 or 16 weeks.

Neural Tube Defects (NTD):

An abnormality where the spine has not close over the central nervous tissue. Of this ‘Lesson’ is
of the head, the condition is called Anencephaly and is incompatible with life. If it occurs
anywhere lower down the spine it is called spine bifid and results in varying degrees of physical
and mental disabilities, ultrasound scanning is the way in which these abnormalities are
conformed.

Nuchal Scan:

Between 11-13 weeks of pregnancy, the fluid at the bad of the babies neck, the nuchal
translucency from the scan.
Patau’s Syndrome:

A chromosome abnormality in which there are 3 copies of chromosome 13 resisted of 2 it is also

called trisomy 13. Babies with a full trisomy 13 may not survive pregnancy.

Scans:

Also ultrasound scanning to confirm abnormalities of the fetus.

Syndrome:

Combination of symptoms sign groups together to form a disorder.

Tripple Test:

This test has many names, it may be called the lead; text, the Bart’s test or the Blood test a
sample of blood is taken usually between 16 –18 weeks of pregnancy. The stage of pregnancy is
best estimated by an ultrasound-dating scan.

Trisomy:

Were there are 3 chromosomes rather than the usual pair, this is called a trisomy.

Ultrasound Scanning:

This is a technique used routinely in most hospitals is monitor the growth and development of
the baby before 16 weeks use useful for dating the pregnancy land are able to detect some major
malformations) detailed scanning of 18 – 21 weeks should show up any major deformation as
well as some minor ones.

PAPP-A

Pregnancy Associated Plasma Protein- A

Free & HCG

Free Beta Human Chorinic Gonadotropthin

CSF

Ceresco spinal Fluid.

WHO: World Health Organization

ACM: Antenatal Care Mode

CHAPTER TWO

LITERATURE REVIEW

2.1 Theoretical Review of Antenatal Care And Antenatal Units

It is well known that Antenatal Care is more beneficial in preventing adverse pregnancy
outcomes when received early in the pregnancy and continued through delivery (Klemm et al.,
2015). WHO recommends that a woman without complications should have at least four ANC
visits, the first of which should take place during the first trimester (Lincetto, Mothebesoane-
Anoh, Gomez, & Munjanja, 2015) Quality and uptake of ANC were key components in each of
the projects and we developed indicators to capture the status of these components. These
include percentage of mothers attending one or more antenatal visit; percentage of mothers
attending four or more antenatal visit; percentage of mothers receiving first antenatal visit during
the first trimester; percentage of mothers who received advice about the importance of having
ANC visit; percentage of mothers who received advice about when to start the ANC visit; and
percentage of mothers who received advice about the importance of having at least four ANC
visits.

Women in FGLS (The Fetal Growth Longitudinal Study) received standardized antenatal care
based on the recommended WHO new antenatal care package (modified or upgraded according
to local practices).1Allparticipants were followed throughout pregnancy from their first clinic
visit, irrespective of the pregnancy out-come. As a general principle, the number of exclusions
from the analysis for the creation of the final fetal growth standards will be as small as possible.
They will be confined to fetuses with congenital abnormalities (based on a final evaluation at
birth); multiple pregnancies that were not identified at recruitment; mothers diagnosed with cata-
strophic fetal death or very severe medical conditions not evident at recruitment (e.g. cancer,
HIV); those with severe pregnancy-related conditions requiring hospital admission(e.g.
eclampsia or severe pre-eclampsia), and those found later in pregnancy to fulfil one of the
exclusion criteria(e.g. women who started to smoke during pregnancy).Hospital admission per se
is not a reason for exclusion: women admitted simply for ‘observation’ still contribute data to the
fetal growth standards unless they developed one of the conditions listed above. All sites are
malaria-freedom-zones. Nevertheless, we adhered to local protocols and excluded from
incorporation in the fetal growth

Antenatal care (ANC) is a vital component of reducing maternal and infant morbidity and
mortality during pregnancy and birth, by treating and monitoring complications. Globally, about
500,000 women die as a result of pregnancy and birth complications. The World Health
Organization recommends that women have at least four ANC appointments, with additional
appointments if they are experiencing any complications. The first appointment should occur
within the first 4 months of pregnancy. However, many women globally are not offered, or do
not attend, this level of care, with less than two thirds having at least four appointments. These
figures are much lower in developing regions, with only 68% ever attending care, and just 39%
meeting the target of four or more appointments.

Antenatal care is available in Nigeria, with women having uncomplicated pregnancies offered at
least eight appointments throughout their pregnancy, starting in their first trimester. However
low attendance is a significant issue. Although almost all women attend one appointment, there
is a particular issue with women not booking follow up appointments or missing booked
appointments. One study estimated there to be an average non-attendance rate of 30% in public
hospitals. This is not because women in Nigeria are having uncomplicated pregnancies and
births; Nigeria has a maternal death rate of 24 in 100,000 and a still birth rate of 12.9%.
Variation between regions is seen with mortality rates highest in rural and poorer regions.
Understanding why women are not attending ANC in Nigeria is a government priority but
research exploring this issue is sparse. For example, one interview-based study with pregnant
women who had missed appointments identified a perceived lack of respectful communication
from staff, and clinics that were not well equipped. Conversely, other research in the area has
simply focused on exploring whether mothers value care rather than barriers to attendance.
Notably, each study examining this issue concluded that mothers did value care, suggesting
further barriers are likely to be preventing attendance.

Whilst health professionals believed maternal low literacy and education affected maternal
attendance, mothers described negative staff attitudes and disrespectful communication as
reasons for non-attendance.

standards any woman with evidence of malaria infection during the pregnancy. The final
definitions of these conditions were approved by the Project Steering Committee before
analyzing any data. To date, FGLS has had fewer follow-up problems than many of our previous
randomized controlled trials. This was expected because we are studying well-educated women
who are enthusiastic about the aims of the study. Nevertheless, to ensure that the loss to follow-
up remains as low as possible, we maintain very close contact with participants, reminding them
about imminent visits and conducting home visits if necessary.

The rapid development of ICT (Information Communication Technology) in the past few
decades has tremendously changed the life style of human beings around the world. This
improves the knowledge and provides a quality life style to everyone. Today 40% of the world
population use internet whereas in year 2013 37.9% of them have had access to it
(http://www.internetlivestats.com/). This evolution in usage of internet has made people to gain
more and more knowledge and makes them experts.The development of advanced technologies
in search engines like google, yahoo search, top search and social media like Facebook, twitter,
blogs and IT device such as mobile phones, laptops and desktops have become store houses of
information. The social media has completely transformed the way people consume information.
Pregnancy is an important phase in a woman’s life although the sources of information have
varied over time and between places Presently internet has become a powerful informative tool
for obtaining such information and all literate women are aware of its usage. It is believed that
women often turn to internet to seek information related to pregnancy. Margareta Larsson et al.
Study finds out Swedish pregnant women often use internet for seeking information related to
pregnancy. In results of the study 91% of the women had access to Internet and 84% of them
used internet most frequently, most often in the early stages of their pregnancy and 55% of them
always crosschecked that information that were given by the midwives with the internet.
Similarly, Declercq ER et al. points out that internet use among pregnant women are common
and frequent and this caused decline attendance at childbirth education classes. According to a
mother ‘survey, participation in childbirth classes dropped from 70% to 56% among first-time
mothers and from 19% to 9% among experienced mothers. There are many advantages in using
internet. A woman user can switch over from printed books or magazines into an electronic
format such as their online versions. This offers fast access and more updates compared to the
printed versions. Moreover, the readers are free to filter the contents according to their
preferences and they tend to get an opportunity to give feedbacks or share their opinion with
others on the articles in a blog or a website. If they feel they need guidance from an expert they
can easily mail them or text them in a social network so that they can respond to their queries
immediately.

2.1.1 Factors Affecting Antenatal Care

1. Maternal factors
o Age of women
o Timing of ANC
o Education status
2. Household factors
o Wealth status
o Permission to seek health
o Media exposure
3. Health Institution factors
o Distance to health facility
o Nurses and midwives
o Quality of care
o Healthcare support
 o Health insurance

2.1.2 Problems Affecting Operation of Antenatal Care Services in Nigeria

There are many factors that act as barriers to effective antenatal care:

1. poor access—due to inadequate or non-existing communication facilities.

2. poverty—services not affordable because of commercialization of health services and
high cost of living
3. prevailing cultural norm—where women need their spouses’ consent before receiving
care and the examination of a woman by a male obstetrician is not acceptable
4. patient’s perception of the quality of antenatal care services which is negatively affected
by(i)prolonged outpatient waiting time, (ii)increasing interventions, for example,
induction of labor, caesarean section, and blood transfusions, (iii)unprofessional conduct
of service providers, (iv)superstition with the trend of ascribing complications during
pregnancy and labor to spiritual attack
5. personnel cost in terms of poor remunerations and long hours of work
6. paralysis of emergency obstetric care due to inadequate facilities on ground
7. perennial power outage.

2.1.3 Importance of Antenatal Care

Pregnancy is a crucial time to promote healthy behaviors and parenting skills. Good ANC links
the woman and her family with the formal health system, increases the chance of using a skilled
attendant at birth and contributes to good health through the life cycle.

The aims of antenatal care are to optimize maternal and fetal health, to offer women maternal and fetal
screening, to make medical or social interventions available to women where indicated, to improve
women's experience of pregnancy and birth and to prepare women for motherhood whatever their risk
status.

The major aims of antenatal care are:

 1. promote and maintain the physical, mental, and social health of mother and baby by providing
education on nutrition, personal hygiene, and birthing process
2. detect and manage complications during pregnancy, whether medical, surgical, or obstetrical
3. develop birth preparedness

The purpose of antenatal care is to prevent or identify and treat conditions that may threaten the
health of the fetus/newborn and/or the mother, and to help a woman approach pregnancy and
birth as positive experiences.

Why are antenatal appointments important?

Regular antenatal appointments are important to:

1. keep an eye on how your baby is growing.

2. pick up some conditions such as pre-eclampsia and urinary tract infections – these might
not have any early symptoms that you would notice but routine blood-pressure checks
and urine tests can pick up on them, even if you feel fine
3. check the health of your baby through blood tests and ultrasound scans.

2.1.4 The Antenatal System

Hospital systems are complex systems built in order to capture, store, organize, process and
transmit patient’s records and also to ease the various processes and activities within the hospital
for the purpose of improving the quality, efficiency and performance of service delivery to the
teaming population of patients within and outside the hospital. Hospital Information system
automate the whole hospital processes so as to achieve the above-mentioned requirements. These
systems have various smaller sub components (systems) which when integrated together give
rise to single large Hospital information systems. These smaller sub-components or systems
include: Laboratory information system, Nursing Information System, Patient Record
Information System, Pharmacy Information System and lots more. These sub-systems if properly
implemented will definitely lead to improve performance, quality and efficiency of the whole
hospital operations and service delivery and satisfaction to patients.

The main purpose of any healthcare institution is to save lives by treating patients from various
illnesses. These sub-components mentioned above of any hospital system work hand in hand
with each other to ensure patients safety and health condition. A normal or basic hospital routine
on the treatment of patients is for patients to see a doctor after booking an appointment, patient
diagnosis by a doctor, doctor gives prescription to patient, doctor sends a patient to either
pharmacy to get prescribed drugs or to the lab for tests, doctor can also admit patient and lots
more. All these processes when carefully observed form the various sub-components of a
hospital management system mentioned earlier. A clinical routine or component of a hospital
management system often neglected and not been automated or integrated into most existing
systems is the antenatal and postnatal care services for pregnant women. Antenatal care services
are rendered to a pregnant woman throughout the pregnancy period until the day she gives birth.
This service is to ensure that the mother and the baby are in good condition, so as to ensure safe
delivery of both mother and fetus. Postnatal service is rendered to a woman who has delivered
successfully. This service is to ensure the healthy growth of the baby from the time he/she is
delivered to when he/she is about a year old. This is also to protect the baby from diseases that
may hinder the healthy growth of the baby. In this work, the antenatal and postnatal care services
are automated and integrated within the normal hospital patient to doctor processes in order to
provide a lot of benefits to the patients.
The automation will help in the generation of reports to monitor the quality of care, efficiency,
and effectiveness of pregnancy care. The reports that could be generated are: maternal or infant
mortality, mortality rates, number of successful deliveries, women expected to deliver at a given
month, a monthly rate of the antenatal and postnatal visit which will determine value it has to the
community and a lot more of other reports not listed. Lecture given to pregnant women during
the antenatal visit is automated as tutorials on web pages to educate women about pregnancy
safety tips. This will benefit not only the registered pregnant women but also the community at
large as anyone with access to the portal will benefit since it is online.

Antenatal systems are systems built in order to capture, store, organize, process and transmit
patient’s (pregnant woman) records and also to ease the various processes and activities within
the antenatal unit or maternity of a hospital for the purpose of improving the quality, efficiency
and performance of service delivery and reduction of mortality rates infants.
2.1.5 Records or Information’s Processed by The Antenatal System
1) Schedule of ante natal check-ups

Every pregnant woman need to have atelast four antenatal check-ups. It should be
emphasized that this is only a minimum requirement and that more visits may be necessary,
depending on the woman's condition and needs. The suggested schedule for antenatal visits is
as follows.

1. Timing of the first visit/registration - The first visit or registration of a pregnant woman
for ANC should take place as soon as the pregnancy is suspected. Every woman in the
reproductive age group should be encouraged to visit her health provider if she believes
she is pregnant. Ideally, the first visit should take place within 12 weeks
2. Second visit - Between 14 and 26 weeks
3. Third visit - Between 28 and 34 weeks
4. Fourth visit - Between 36 weeks and term

2) Components of Ante natal check-up

History Taking

A detailed history of the woman needs to be taken to:

1. Confirm the pregnancy (first visit only).

2. Identify whether there were complications during any previous
pregnancy/confinement that may have a bearing on the present one.
3. Identify any current medical/surgical or obstetric condition(s) that may complicate the
present pregnancy.
4. Menstrual history to calculate the Expected Date of Delivery
5. Ask her about the Nausea and vomiting / Heartburn / Constipation / Increased
frequency of urination
6. Ask about symptoms indicating complications:
o Fever
o Persistent vomiting
 o Abnormal vaginal discharge/itching
o Palpitations, easy fatigability
o Breathlessness at rest/on mild exertion
o Generalized swelling of the body, puffiness of the face
o Severe headache and blurring of vision
o Passing smaller amounts of urine and burning sensation during micturition
o Vaginal bleeding
o Decreased or absent fetal movement
o Leaking of watery fluid per vaginum (P/V)
7. Ask about her previous pregnancies or obstetric history
o Ask about the number of previous pregnancies. Confirm whether they were all
live births, and if there was any stillbirth, abortion or any child who died.
o Ascertain the date and outcome of each event, along with the birth weight, if
known. Find out if there was any adverse perinatal (period between 7 days
before birth and 28 days after birth) outcome.
o Obtain information about any obstetric complications and events in the
previous pregnancies – Recurrent early abortion/ Post-abortion
complications /Hypertension, pre-eclampsia or eclampsia / Ante-Partum
Hemorrhage (APH) / Breech or transverse presentation / Obstructed labor,
including dystocia / Perineal injuries/tears / Excessive bleeding after delivery /
Puerperal sepsis.
o Ascertain whether the woman has had any obstetrical operations (caesarean
sections/ instrumental delivery/vaginal or breech delivery/manual removal of
the placenta).
o Ask for a history of blood transfusions.
8. History of any current systemic illness / past history of illness
o High blood pressure (hypertension)
o Diabetes
o Breathlessness on exertion, palpitations (heart disease)
o Chronic cough, blood in the sputum, prolonged fever (tuberculosis)
o Renal disease
 o Convulsions (epilepsy)
o Attacks of breathlessness or asthma
o Jaundice
o Malaria
o Other illnesses, e.g. Reproductive Tract Infection (RTI), Sexually Transmitted
Infection (STI) and HIV/AIDS. Family history of systemic illness
o History of intake of habit-forming or harmful substances - Chews or smokes
tobacco and/or takes alcohol.

Physical Examination

General examination

 Pallor
 Pulse
 Respiratory rate
 Jaundice
 Edema
 Blood pressure
 Weight
 Breast examination

Abdominal examination

 Measurement of fundal height

 Determination of fetal lie and presentation by fundal palpation, lateral palpation and
pelvic grips
 Auscultation of the Fetal Heart Sounds
 Inspection of scars/any other relevant abdominal findings.

Laboratory Investigations

 Urine Pregnancy test

  Blood investigations for Hemoglobin estimation and blood grouping including Rh
factor
 Urine test to assess the presence of sugar and proteins
 Rapid test for malaria and syphilis

Interventions

 Iron Folic Acid (IFA) supplementation along with counseling about the necessity of
taking IFA and the dangers associated with anemia
 Administration of TT injection - two doses of TT injection for prevention of maternal
and neonatal tetanus (tetanus of the newborn).

Micro-Birth Planning and Counseling

 Registration of pregnant woman and filling up of the Maternal and Child Protection
Card and JSY card/below poverty line (BPL) certificates/necessary proofs or
certificates for the purpose of keeping a record.
 Informing the woman about the dates of antenatal visits, schedule for TT injections
and the Expected Date of Delivery.
 Identifying the place of delivery and the person who would conduct the delivery.
 Identifying a referral facility and the mode of referral.

INFORMATION TECHNOLOGY

Information technology, as defined by the Information Technology Association of America

(ITAA), is "the study, design, development, implementation, support or management of
computer-based information systems, particularly software applications and computer
hardware." Encompassing the computer and information systems industries, information
technology is the capability to electronically input, process, store, output, transmit, and receive
data and information, including text, graphics, sound, and video, as well as the ability to control
machines of all kinds electronically.
Information technology is comprised of computers, networks, satellite communications, robotics,
videotext, cable television, electronic mail ("e-mail"), electronic games, and automated office
equipment. The information industry consists of all computer, communications, and electronics-
related organizations, including hardware, software, and services. Completing tasks using
information technology results in rapid processing and information mobility, as well as improved
reliability and integrity of processed information.

2.1.6 Information Technology's Role Today

Every day, people use computers in new ways. Computers are increasingly affordable; they
continue to be more powerful as information-processing tools as well as easier to use.

Computers in Business

One of the first and largest applications of computers is keeping and managing business and
financial records. Most large companies keep the employment records of all their workers in
large databases that are managed by computer programs. Similar programs and databases are
used in such business functions as billing customers; tracking payments received and payments
to be made; and tracking supplies needed and items produced, stored, shipped, and sold. In fact,
practically all the information companies need to do business involves the use of computers and
information technology.

On a smaller scale, many businesses have replaced cash registers with point-of-sale (POS)
terminals. These POS terminals not only print a sales receipt for the customer but also send
information to a computer database when each item is sold to maintain an inventory of items on
hand and items to be ordered. Computers have also become very important in modern factories.
Computer-controlled robots now do tasks that are hot, heavy, or hazardous. Robots are also used
to do routine, repetitive tasks in which boredom or fatigue can lead to poor

quality work.

Computers in Medicine

Information technology plays an important role in medicine. For example, a scanner takes a
series of pictures of the body by means of computerized axial tomography (CAT) or magnetic
resonance imaging (MRI). A computer then combines the pictures to produce detailed three-
dimensional images of the body's organs. In addition, the MRI produces images that show
changes in body chemistry and blood flow.

Computers in Science and Engineering

Using supercomputers, meteorologists predict future weather by using a combination of

observations of weather conditions from many sources, a mathematical representation of the
behavior of the atmosphere, and geographic data. Computer-aided design and computer-aided
manufacturing programs, often called CAD/CAM, have led to improved products in many fields,
especially where designs tend to be very detailed. Computer programs make it possible for
engineers to analyze designs of complex structures such as power plants and space stations.

Integrated Information Systems

With today's sophisticated hardware, software, and communications technologies, it is often

difficult to classify a system as belonging uniquely to one specific application program.
Organizations increasingly are consolidating their information needs into a single, integrated
information system. One example is SAP, a German software package that runs on mainframe
computers and provides an enterprise-wide solution for information technologies. It is a powerful
database that enables companies to organize all their data into a single database, then choose
only the program modules or tables they want. The freestanding modules are customized to fit
each customer's needs.

SOFTWARE

Computer software consists of the programs, or lists of instructions, that control the operation of
a computer. Application software can be used for the following purposes:

 As a productivity/business tool
 To assist with graphics and multimedia projects
 To support household activities, for personal business, or for education
 To facilitate communications
Productivity Software

Productivity software is designed to make people more effective and efficient when performing
daily activities. It includes applications such as word processing, spreadsheets, databases,
presentation graphics, personal information management, graphics and multimedia,
communications, and other related types of software. Word-processing software is used to
create documents such as letters, memos, reports, mailing labels, and newsletters. This software
is used to create attractive and professional-looking documents that are stored electronically,
allowing them to be retrieved and revised. The software provides tools to correct spelling and
grammatical mistakes, permits copying and moving text without rekeying, and provides tools to
enhance the format of documents. Electronic spreadsheet software is used in business
environments to perform numeric calculations rapidly and accurately. Data are keyed into rows
and columns on a worksheet, and formulas and functions are used to make fast and accurate
calculations. Spreadsheets are used for "what-if" analyses and for creating charts based on
information in a worksheet. A database is a collection of data organized in a manner that allows
access, retrieval, and use of that data. A database management system (DBMS) is used to
create a computerized database; add, change, and delete data; sort and retrieve data from the
database and create forms and reports using the data in the database. Presentation graphics
software is used to create presentations, which can include clip-art images, pictures, video clips,
and audio clips as well as text. A personal information manager is a software application that
includes an appointment calendar, address book, and notepad to help organize personal
information such as appointments and task lists. Engineers, architects, desktop publishers, and
graphic artists often use graphics and multimedia software such as computer aided design,
desktop publishing, video and audio entertainment, and Web page authoring. Software for
communications includes groupware, e-mail, and Web browsers.

Storage devices: Storage devices retain items such as data, instructions, and information for
retrieval and future use. They include floppy disks or diskettes, hard disks, compact discs (both
read-only and disc-recordable), tapes, PC cards, Smart Cards, microfilm, and microfiche.

INFORMATION AND DATA PROCESSING

Data processing is the input, verification, organization, storage, retrieval, transformation, and
extraction of information from data. The term is usually associated with commercial applications
such as inventory control or payroll. An information system refers to business applications of
computers and consists of the databases, application programs, and manual and machine
procedures and computer systems that process data. Databases store the master files of the
business and its transaction files. Application programs provide the data entry, updating, and
query and report processing. Manual procedures document the workflow, showing how the data
are obtained for input and how the system's output is distributed. Machine procedures instruct the
computers how to perform batch-processing activities, in which the output of one program is
automatically ted into another program. Daily processing is the interactive, real time processing
of transactions. Batch-processing programs are run at the end of the day (or some other period)
to update the master files that have not been updated Since the last cycle. Reports are printed for
the cycle's activities. Periodic processing of an information system involves updating of the
master files adding, deleting, and changing the information about customers, employees,
vendors, and products.

2.2 REVIEW OF RELATED WORK

Authors proposed an Online Antenatal Consultation System (OACS) using Unified Modeling
Language (UML) web engineering approach so as to reduce the rate of infant and maternal
mortality in rural areas of Nigeria. The system is aimed at providing quality antenatal support to
pregnant women in rural areas of Nigeria. It is accessible to pregnant women, doctors, nurses
through the use of the following devices: PC, Desktop, Laptop, Palmtop, and mobile devices
such as smartphones, tablets, and Android gadgets. The OACS Administrators manages the use
and operation of the system by generating pins, reports of pins, users etc. these pins are required
during by users during registration and login to the system. A patient can register herself or by
the help of the staff nurses for those patients who can`t register by themselves. A patient can
have full access to her profile where she can book for an appointment with a doctor nurse, lay
complaints, receives results and prescriptions online from a doctor or nurse. Doctors and nurses
also must be registered on the system using pins generated and issued by the administrator. A
doctor can view patients complains, offer prescription, give advice to patients, sends messages
etc. Nurses can view appointments from patients and assigns an appointment with a doctor. The
OCAS has a lot of weakness as it is only designed to provide support to pregnant women in rural
areas who cannot have access to a primary healthcare facility due to the long distance. Women
who do not have mobile phones or other devices to access the system cannot benefit from the
system. Antenatal routine checkup, clinical test and physical evaluation by a doctor are not
captured by the system. Therefore, few reports can be generated whereby those relevant reports
that can enhance decision making might not be captured or generated as reports. Reports
generated cannot be exported into a suitable format for use. However, the security of the system
is considered as a user must first register using secure pins generated by the Administrator and
must log in after registration using a password before having access to the system.

Pam Lowe et al. indicate women are encouraged to know about pregnancy in a formal method
(e.g., information leaflets, antenatal classes, books). In addition, informal stories on pregnancy
and birth are routinely shared between them. Traditional information cannot cover all possible
outcomes, and the internet is one of the effective medias to fill these gaps.

Lagan BM et al. assert that internet access and usage is almost universal, providing new chances
and increasing challenges for health care practitioners, with pregnant women apparently turning
to the new media for information during pregnancy.

Jayanthi Maniam argue that there is lots of information widely available in printed form but
usually this information is general, too lengthy and complicated. One of the very easy and fast
ways to access information about pregnancy is internet.

According to child birth connection survey in 2014 many women used subscription services
like newsletters for delivery of pregnancy and birth information. Many women received regular
information about pregnancy and birth from a content provider: 67% signed up to receive weekly
emails on pre and post pregnancy.

Larsson et al: In olden days, midwives, obstetricians, general practitioners and pediatricians had
been the main information providers to women on their pregnancy, care and treatment, but there
are a mounting number of articles which indicate that there may be a shift as women go often to
new media for seeking health information. Larsson et al conducted a study in Sweden in which
84% of women sought pregnancy information online, the median number of searches per month
were four, with some women reporting going online for pregnancy information as often as twice
each day and they feel they getting adequate information which they are in need. The internet
was named by pregnant women as an adequate trusted source for advice on the use of home
remedies to maintain their health during pregnancy; however, due to the small (n=27)
nonrandom design, and geographic specificity of the study, no generalizations could be made.
National Partnership for Women and Families conducted a survey in 2014 whose result was that
nearly 64% of pregnant women in the survey accessed online information through smartphones
in a week to clear their doubts, and 82% accessed the net using computers

Researchers Lagan et al. indicates that nearly half of the respondents reported dissatisfaction
with information given by health professionals (48.6%) and lack of time to ask health
professionals questions (46.5%) as key factors influencing them to access the Internet.
Statistically, women's confidence levels significantly increased with respect to clearing their
doubts about their pregnancy after Internet usage (p < 0.05).

JoAnne Herman et al. explores that discussion board is the most effective way to deliver
informational social support on a comprehensive social support web site. Participants were able
to take tips from Web site easily. They accessed the discussion board the most frequently,
followed by changes during pregnancy by month, ask-a-nurse feature, ultrasound, stories about
pregnant women, and spirituality.

In another study by Carina Sparud-Lundin et al. explain about the importance of the web-
based tips need for women with type 1 diabetes in relation to childbearing. This user directed
study indicates specific areas of development for the provision of effective web-based support
that includes facilities for reliable information, interactive support and social networking in this
population.

Kate Rope argues, according to the Centers for Disease Control and Prevention (CDC), 90
percent of women take medication at some point in their pregnancy and 70 percent take
prescription medication. And yet women facing these decisions are often given conflicting
information on medication safety from their primary care providers and the Internet.
Katri Hameen-Anttila concluded in their study a large proportion of pregnant women report the
need for information about medicines during pregnancy, 73% rely on healthcare professionals
and 60% rely on internet it is a widely used information source across the countries in this study.
Tares comments on how women need to connect and bond with one another during pregnancy,
and to rely on other women for support. DIPEx.org is an example of a website developed in the
UK where women can listen to a number of different audio-visual interviews of women talking
about their experience of antenatal screening, as well as accessing information on treatment
choices and where to find support.

Capitulo’s qualitative study using ethnography to describe and interpret the culture of an online
perinatal loss group, found the essence of the culture was ‘shared metamorphosis’. The culture of
online support can link individuals who are geographically distant but share common issues. The
internet linked women together who otherwise would not have met. Participants shared virtual
identities, created a community and by joining the perinatal loss listserv ensured that they would
never be alone.

Rillstone in his exploratory descriptive study noted how some women who had a previous
pregnancy with a fetal abnornality benefited from accessing the internet for support when faced
with a subsequent pregnancy. Pemberton and Goldblatt give an example of a case study where a
pregnant woman carrying a baby with a congenital abnormality sourced information from the
internet.

Devan Mcguinness found out in her study that pregnant women admit to getting lots of
information from the internet and say that it is very reliable and useful. They also cross check
few things once in a while, but the information is so valuable.

Internet is used as a medium of information among women, they access it to know what they
need, and it is one of the fastest-growing informative medium covering a wide range of audience.
It gives information on various health-related issues, including pregnancy and child development
stage by stage Margareta Larsson, points out in the study that 91% of the female accessed
internet in which 84% used it to collect and to retrieve information on a most interested search
was on fetal development and child development.
Jay M Bernhardt The mothers in our study reported going online to learn more about the stages
of fetal and child development, especially for their first child. The information that these women
found most useful were messages that were matched, or tailored, to their specific stage of
pregnancy or the developmental stage of their child.

Yet another study by Ernst and Schmidt stated how internet obscures people on giving
information about herbal medicine. This was a good example of how advice given via the new
media can be unclear, incorrect, lacking in scientific rationale and does not always provide
warning information; this may put women and their fetuses at risk. Women from various parts of
the country have the same tendency proving that internet is the primary and reliable source to
find information related to pregnancy.

A study which was held in Sweden indicates approximately three fourths of the Swedish
survey’s women respondents (exact figure not reported) rated that pregnancy-related information
they found online to be moderately or highly reliable.

2.3 Summary of Related Work and Knowledge Gap

The review of related work shows that existing Computerized Antenatal Systems are mainly for
record keeping.

What about setting appointments for various antenatal check up and being able to remind
patients of their various appoints with doctors, nurses and mid-wives. And constantly remind the
patients of their routines.

Each antenatal appointment should have a structure and a focus. Appointments early in
pregnancy should be longer to provide information and time for discussion about screening so
that women can make informed decisions. If possible, incorporate routine tests into the
appointments to minimize inconvenience to women.

A web-based Antenatal System should be designed and implemented with this feature included
for
Creating and checking appointments: this should be accessible by doctors, nurses, midwives and
the patients too

When women come to register for antenatal for the first time, they should give access to the
system so they could easily view their appointments, the stages of their antenatal care process,
their various status and finally ask FAQs which the doctors would provide their answers.

CHAPTER THREE

SYSTEM ANALYSIS AND METHODOLOGY

METHODOLOGY

Methods To gather important information to identify and analyse users' wants,

needs and beliefs, we applied online questionnaires. This kind of strategy, also
known as market research, is beneficial in providing a better understanding of
users' demands and behaviour, thus, helping in product design. Also, interviews
with a gynecologist-obstetrician doctor were conducted. Therefore, the
requirements (functional and nonfunctional) were raised from both strategies.
Consultations were also held on related work and demonstrations of related
systems. In this way, our intention was to guarantee consistency,
completeness and correctness of the product during the development phase. The
web-based system was designed following the model-view-controller (MVC)
pattern19. The MVC architecture organizes the application into three
interconnected parts: the first (the model) represents an object carrying data;
the second (the view) represents the presentation layer; and the last (the
controller) acts on both, model and view, controlling the data flow updating the
view whenever data changes. This pattern permits a better organization of the
code and allows the development of multiple views for a model. The system will
provide interoperability by a web service application program interface (API)
that adhere to the representational state transfer (REST) architecture20. REST is a
great way to facilitate the access to the logic of the application and the
integration with other systems. The API and the web tool was implemented using
the PHP framework CakePHP that makes building web applications using the MVC
patterns and implementing REST services simpler, faster, while requiring less
code21. The presentation layer was developed using HTML5, CSS and JavaScript.
Also, a mobile application was developed consuming the RESTful API, so the
parturient can always be with her antenatal information when it is needed

2.2 INPUT ANALYSIS

The input forms are designs generally based on the necessary data that needs
to be entered into the system. The data are captured through the keyboard
and stored on a magnetic disk in the database. The new system is composed
mainly of bidding and members inputs,
Process Analysis:
Once the inputs are collected, the obtained data are processed properly for
effective use. The data processed is stored in the database as information for
subsequent use.
MEDICAL CRD

Input data content in due medical card are patient No, Name, Address, Husband’s

Name, occupation, Age of Antenatal mother, Doctor/ nurse incharge, Date. The

format for the medical card for Antenatal mother is as illustrated below.

PARKLANE SPECIALIST HOSPITAL ENUGU

ENUGU STATE

ANTENATAL MEDICAL CARD

Patient Name (surname first) patient N0. _________

Patient Address_________________ Date__________________

Husband’s Name____________________________________________

Husband’s Occupation _____________________________________

Husband’s Address__________________________________________

Age of Patient _______________________________________________

Doctor/ nurse incharge _____________________________________

The registration Book, she is asked to by the medical card of N200 after which a

folder is opened for her, the staff copies her folder number in the index card and

attach 2 continuaiton or check-up card for doctor that would be attending toher
on any antenatal Day(s) to be specified by the doctor/nurse if need be, else she

comes every Wednesday, when she comes for check-up, the nurse/ doctor in-

charge full the necessary column in her Antenatal check-up card. The check-up is

expected to continue till childbirth during which the doctor/ nurse advices the

nursing mother on what to do or take for the health and life her fretus some of

these advice are;-

(1) Regular exercise

(2) Little or no consumption of Antibiotics or other hard drugs by the mother

so that the fretus want be deformed.

(3) The mother should take vegetable and vitamins, which are necessary for

the Childs growth.

(4) The mother should watch the consumption of food, so that the baby won’t

grow too big as it will affect her during labour.

(5) The Doctor gives a profess report of the babies development and balance

(6) Sometimes X-rays are performed to ensure that the baby is still alive and in

good form & weather there are twins or not.

 (7) Hot drinks should be avoided by the mother during this period including

other alcoholic drinks.

Antenatal check up card

Park lane specialist Hospital

Surname Orther Names Ward Unit No

Date Begin Drugs & orther instrument, Discontinued Initial

sign

The check-up card is carried along by the Antenatal mother any day she

visits the hospital for checkup and doctor incharge of her case fills the form

regarding Drugs to minister and orther instrument used if any. The checkup cared

is the property of the Antenatal mother which she safely while the checkup lasts

the contents or input dates of this card as illustrated above.

Antenatal Record Register

This Register the record of all Antenatal patient and their corresponding

particulars patients No, Patient Name, Address, Husbands Name, occupation, Age,

Doctor incharge, diagnoses and patients phone Number. The format is of the sort

below.

Dat Patien Nam Addres Husband Occup Patient Doctor Patient

e t No e s s Name . s Age incharg s

e phone

RECIEPTS

The receipts offered to patients after purchase of drugs or orther

instruments for treatment is another output from the system. it contains output

info’s I like drug/ instrument purchased, details patients name, address.

The Doctor Administers Drugs and advices on foods is be consumed in proportion

for the child development and health.

 All these are some important relevance of Antenatal care is a mother and

proceeds until childbirth.

The input data in the input analysis stage are processed to produce output in

form of reports.

3.4 OUTPUT ANALYSIS

The output from the system designed is generated from the system inputs. More of
the output generated is on Symptoms information from the patient. This involves
the resultant documentation generated after processing of data supplied to the
system.
The output here is the patient status on the diagnosed disease. These outputs can be
generated as softcopy.

SALES REPORT SHEET

This sheet contains information on how much generated from the medical

card of N200 sold to patients which is calculated by multiplying the numebrof

patients for the day by N200, it also contain the amount generated from the sales

of drugs and orther medical instruments like needles and syringes. The format for

the sales report sheets is illustrated.

PARK LANE SPECIALSIT HOSPITAL

ENUGU, ENUGU STATE

SALES REPORT SHEET DATE

No of patients______________________________________________

Amount generated _________________________ outpatient staff sign No of

drugs sold and descriptions.

Amount generated___________________ signature of doctor/ nurse

TOTAL

______________________________

Accountant’s signature

3.5 ANTENATAL UNIT STRUCTUURE

SALES ANALYSES ANTENATAL UNIT RECORD DEPT

HEAD OF DEPT ANTENATAL
ATTENDANCE
UNIT
SECRETORY
SUPERVISOR 2 SUPERVISOR 1 SUPERVISOR 3
STORE OFFICER FOLDER MOVEMENT
REEGISTRATION
MESSANGER THAT
ACCOMPANIES PATIENT TO
THEIR WARD

Date, Amount, Receiver Sign and patients signs, the format is mustrated below
PARK LANE SPECIALIST HOSPITAL

RECIEPT

REVENUE COLLECOTRS NAME DATE

RECEIVED FROM

The sum of ---------- k AMT in WORDS

BEING HOSPITAL FEE AS PER DETAILS BELOW

ITEM DETAILS ACCOUNTS CODE AMT K

TOTAL

Signature Of Revenue Collector

3.6 PROBLEM OF THE EXISTING SYSTEM

The problem associated with the existing manual system are enumerated as
 (1. TEDIOUS: through the input data to be processed are always available, but

the method of processing employed is inappropriate, this leading to

accumulation of work.

(2. INCOMPLETENESS: Certain data to be processed are over cooked due to

their bully nature, this leads incompleteness and unreliable information.

(3. TIME LAG:- the tune between a patients arrival and completion of the

processes is cory. This frustrates some Antenatal mother and causes them

to leave the hospital for registration else where for Antenatal care.

Updating is difficulties because files are not easily accessed.

3.7 OBJECTIVE OF THE EXISTING SYSTEM

As earlier stated in chapter one, this work is aimed at developing and

implementing an integrated computerized Antenatal information system with

Park lane Specialist Hospital as case study so as to

1) To improve quality of service and ensure patient satisfactory

2) to increase operational accuracy and efficiency

3) To generate on-line periodic or ad hoe information which must be

consistent timely, accurate possible and reliable

 CHAPTER FOUR

SYSTEM DESIGN AND IMPLEMENTATION

4.1 The Objectives of Design

1. Correctness: Software design should be correct as per requirement.

2. Completeness: The design should have all components like data structures, modules, and
external interfaces, etc.
3. Efficiency: Resources should be used efficiently by the program.
4. Flexibility: Able to modify on changing needs.
5. Consistency: There should not be any inconsistency in the design.
6. Maintainability: The design should be so simple so that it can be easily maintainable by
other designers.

4.2 Main Menu

Fig 4.1 the main menu.

Main Menu

Maternity Doctor Exit

4.3 Submenus
Main Menu

Maternity Exit
Doctors

Patient Appointments
antenatal
record Patient
Antenatal
Patient
record
Visit
history
Prescriptions
Appointments

Fig 4.2 submenus.

4.4 System Specification

A system specification is a set of documentation that describes the features and behavior of a
system or software application. It helps to define the operational and performance guidelines for
a system. It may outline how the system is expected to perform, and what that may include. Key
specifications may include interface definitions, document design rules and functional areas.

When purchasing software or a computer, system specifications may be outlined during the
evaluation process and agreed upon during the payment process. The specifications may
determine security access. Many organizations will offer templates and resources to help
facilitate the adherence of system specifications. In some cases, system specifications can be
quite specific and difficult to follow without these guidelines.
4.4.1 Database Development tool

SQL Server Management Studio (SSMS) is a software application first launched with
Microsoft SQL Server 2005 that is used for configuring, managing, and administering all
components within Microsoft SQL Server. It is the successor to the Enterprise Manager in SQL
2000 or before. The tool includes both script editors and graphical tools which work with objects
and features of the server.

A central feature of SSMS is the Object Explorer, which allows the user to browse, select, and
act upon any of the objects within the server. It also shipped a separate Express edition that could
be freely downloaded, however recent versions of SSMS are fully capable of connecting to and
manage any SQL Server Express instance. Microsoft also incorporated backwards compatibility
for older versions of SQL Server thus allowing a newer version of SSMS to connect to older
versions of SQL Server instances. It also comes with Microsoft SQL Server Express 2012, or
users can download it separately.

4.4.2 Database Design and Structure

Table 1 Patients information

Fieldname Data type Description

PatientId Number Patient id
Surname Varchar(225) Surname
Firstname Varchar(225) Firstname
Email Varchar(225) Email(Username)
PhoneNumber Varchar(30) Phone number
Sex Varchar(10) gender
Address Varchar(225) Address
Age int(10) Age

Table 2. Patients Antenatal record

 Fieldname Data type Description
ID Int(5) ID
PatientID Varchar(225) PatientID
DoctorID Int(5) DoctorId
PragnancyDuration DateTime(225) PragnancyDuration
Symptoms Varchar(30) Symptoms
Report Text Report
PrescribedDrugs Varchar(225) PrescribedDrugs
Remedy Varchar(225) Remedy
Checkingdate DateTime Checkingdate

Table 3 Doctors Registrations

Fieldname Data type Description

NameId Number Patient id
DoctorName Varchar(225) Surname
Firstname Varchar(225) Firstname
Email Varchar(225) Email(Username)
PhoneNumber Varchar(30) Phone number
Sex Varchar(10) gender
Address Varchar(225) Address
Age int(10) Age
Specialization text specialization

Table 4 appointments
FIELD NAME DATA TYPE DESCRIPTION
PatientId number PatientId
DoctorsId number DoctorsId
AppointmentDate DateTime AppointmentDate
status text status
report text report
assignedDoctor text assignedDoctor

4.4.3 System Flowchart Design

START

Lunch Web Browser

Locate the Website Address

Key in the required

Inputs

DISK STORAGE
Web Operations

OUTPUT
RESULT

STOP
Fig 4.3 System Flowchart

4.4.4 System Implementation

System implementation is a collection of inter-dependent physical devices together with their

programming which provides the functionality and performance for which the system was
designed. It covers all the activities necessary to set the system that has been analyzed and
designed to be fully functional to the users.
4.5 System Requirement

4.5.1 Software Requirements

1. A windows XP or higher version operating system
2. SQL Server
3. Internet explorer
4. Visual Studio
5. C# programming Language
4.5.2 Hardware Requirements
The software designed needed the following hardware for an effective operation of the newly
designed system.
1. Pentium IV system

2. At least 256MB of RAM

3. Enhanced keyboard

4. 20GB hard disk space

5. SVGA monitor
6. Mouse

4.5.3 Choice of Program Environment

May refer to the coding of an individual software program or to the creation on an entire
information system and all related software.
The development tools are the necessary requirement tools used during the design to enable us
achieve the system design. The listed packages were used because of their features, accessibility
and also because it is more effective.
1. Microsoft Visual Studio: Its an Integrated development Environment(IDE) from Microsoft. It
is used to develop computer programs, as well as websites, web apps, web services and Mobile
App. It supports 36 different programing languages and allows the code editor or debugger to
support any programming language, provided a language-specific service exists

2. SQL server management studio: SQL Server Management Studio (SSMS) is a software
application first launched with Microsoft SQL Server 2005 that is used for configuring,
managing, and administering all components within Microsoft SQL Server. It is the successor to
the Enterprise Manager in SQL 2000 or before. The tool includes both script editors and
graphical tools which work with objects and features of the server.

A central feature of SSMS is the Object Explorer, which allows the user to browse, select, and
act upon any of the objects within the server. It also shipped a separate Express edition that could
be freely downloaded, however recent versions of SSMS are fully capable of connecting to and
manage any SQL Server Express instance. Microsoft also incorporated backwards compatibility
for older versions of SQL Server thus allowing a newer version of SSMS to connect to older
versions of SQL Server instances.

3. ASP.NET MVC: Dotnet framework is a developer platform made up of tools, programing

languages, and library for building many different types of applications. It comprises both
frontend and backend languages. The ASP.NET is an open source, server-side, web application
framework designed for web development to produce dynamic web pages, it allows
programmers to create dynamic web sites, applications and services The ASP.NET is a part of
the .net framework used to create dynamic web pages. Asp.net simplifies the tasks of creating,
debugging and deploying web pages. Its is integrated to Visual Studio and the .net framework, its
application are build on top of software environment (CLR) and can be written in any of the
languages compliant with Dotnet.

The ASP.NET MVC support for MVC (Model View Controller) technology or architecture

1. Model: this are the Domain data, business logics or programs written in c#, contains
entity models.

2. View: This is Client-side, it contains the client-side languages which includes HTML,
CSS, JAVASCRIPT. A client/user clicks on the screen and sends a request to the
controller. Data is outputted here using the razor tags in razor pages. This razor syntax
allows C# to be written along side HTML etc.

3. Controller: This is the Web API, it receives requests and data from the View and fetches
the action or information from the model and returns it back to the View

4.5.4System Testing
45.5Unit Test
Developing a good and logically sound test plan is very vital to developing a bug
free software system. The unit test plan developed for the testing of this application
is as follows:
4.6 Actual Test Result versus Expected Test Result

Table 5 Test plan

s/n Tested Expected Result Actual
Data Result
1 login Expected to login Was able to login
admin and doctor because of correct
identity.
2 Queries To view various Was successful
 information
3 Data connections To see if the interface Was able to connect
and linking is connecting to to database and can
buttons database and view also display other
other pages pages.

4.6.1Performance Evaluation
This software has been tested with data and it is functioning well. This was done
through the use of properly selected input data; ensure reliability and accuracy of
output. The test data consists of formulated Employee details. The respective user
names and passwords, Password were used to login to the database, error message
was displayed if the user’s name and password are incorrect.
All these varying data used in testing the system’s performance, gives the
assurance that the new system will achieve its purpose and objectives.

4.6.2 System Security

The software is incorporated making most of the pages secured or protected which
demands only approved users gaining access to such pages. The secured pages
comprise of the administrator page. The software utilized the C# Administrator to
validate and store user credentials which help manage user authentication.
1. Authentication is the process of inputting a user name and password to gain
access to a specified secured page. It is also important to note that an
authenticated user remains active until the user logs out

4.6.3 Training
After a new system hass been implemented and test, users need to be trained so that is operated
correctly and full benefits are obtained. The type of training depends on the user. Handbooks,
User manual or guide, lectures may be used aids in training of staff.

4.6.4 User Manual

A manual is very essential to help the user know what they are expected to do on a particular
system. The manual is essential for the users that are operating the system and not programmers.

1. Make sure you are using Internet Explorer or Google Chrome or Mozilla Firefox
as your browser.
2. As the administrator, login with your admin password, which was automatically
created.
3. Click the links and buttons provided to navigate to your choice of actions.
4. Input data correctly when need.

4.6.5 System Conversion

This means changing existing systems into a new system. In this project the conversion is
changing manual records to a computerized system and making the software online.

4.6.6 Change Over Procedure

After new system is created, a change over to the new system is made. The three main
procedures for change over are:

1. Parallel change over: the current data is processed by both the old and new system. The
two results are checked again against each other.
2. Pilot change over: current data continues to be processed by old system and previous data
is reprocessed by new system.
3. Direct change over: it involves ceasing the use of the existing system and commencing
the use of the new system immediately.
4.7 Recommend ProcedureI recommend the Parallel change over procedure because this
procedure verifies that the new system is working properly by comparing the results produced by
the systems using the current data.

CHAPTER FIVE

SUMMARY

With an intense penetration of the information communication technology it can be perceived

that there has been a slight transition from the traditional method of information gathering to the
advanced online information sourcing among the Indian pregnant women. As working women,
they spend most of their time in the office in front of computer especially in internet. During
pregnancy the level of usage becomes slightly less comparing the times before pregnancy which
may be due to various reasons. Mercola says women who are pregnant should switch off their
mobile phones and laptops when they are not using it.

CONCLUSION

Antenatal and postnatal processes and services is a component of Hospital Management Systems
that has been given very little attention. Most healthcare institution carries out the antenatal and
postnatal processes manually and keeps records of the whole processes on paper. The idea of an
Antenatal system is as a result to observing the Antenatal care Management and other activities
done in that line in Hospitals, health centers and the levels of distribution and rendering of
services to clients (pregnant women) in that perspective.

RECOMMENDATION

It is important that clinicians do not continue to believe that a lack of scheduling appointments or
proper record keeping is driven solely by poor maternal education and literacy. Although this
may be the case for the most deprived women antenatal care system factors are driving or
missing their appointments, potentially putting their health and that of their baby at risk which
may lead to high mortality rate of infants.
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