Designing and Testing a Nutrition Information System,
A Case Study of Arua Regional Referral Hospital
_______________________________________________
A Project Report
Submitted to the Faculty of Techno-science
In partial fulfillment of the requirements for the award of the degree in
Bachelor of Information Systems of
Muni University
_______________________________________________
By:
Wakalumba Joel
2016/U/ISM/019/G
Anywar Kenneth
2015/U/ISM/039/G
Cadribo Bob Brian
2016/U/ISM/003/P
Lopeyok Benjamin
2015/U/ISM/043/G
December, 2018
i
Declaration
We the undersigned do hereby solemnly declare that except where otherwise indicated this project
report is entirely our original work and has never been submitted in whole or in parts for any other
purpose or award in any university, institution or company to the best of our knowledge for a
degree award.
WAKALUMBA JOEL
2016/U/ISM/019/G
SIGN……………………………………… DATE…………………………………
ANYWAR KENNETH
2015/U/ISM/039/G
SIGN……………………………………… DATE…………………………………
CADRIBO BOB BRIAN
2016/U/ISM/003/P
SIGN……………………………………… DATE…………………………………
LOPEYOK BENJAMIN
2015/U/ISM/043/G
SIGN……………………………………… DATE…………………………………
i
Approval
I certify that this project and report have been completed under my supervision and I recommend
that it should be accepted as a requirement for the award of the Degree of Bachelor of Information
Systems of Muni University, December, 2018.
Sign…………………………………….
Date…………………………………….
Mr. Josephat Oling
ii
Dedication
We give special thanks and deep appreciation to the Almighty God through his mercy and
sympathy for having accomplished the activities. We dedicate all our efforts and struggles of the
educational life to our dear parents, for without them we would not be this far.
We also devote the work of this report to lecturers and management of Muni University they taught
and supported us in developing our personalities and career in the field of Information System
Management as competent professionals.
iii
Acknowledgement
We thank the almighty God for the wisdom, courage, strength, determination and spiritual
direction He bestowed upon us while pursuing this project. We are very grateful to our Supervisor
Mr. Josephat Oling for the constant professional guidance, advice and the good relationship
throughout the completion of the ideas of the project report.
Also in a special way we thank the entire staff of Arua Regional Referral Hospital especially the
Nutrition Department for their cooperation in providing us with the information for the project.
We also thank management of Nutrition Department of Arua Regional Referral Hospital for
allowing us to carry out the project survey in their Department and their willingness to equip us
with the vital information for the project. Special thanks go to the management and the entire staff
of Muni University for providing us with all the knowledge throughout the course of study and
financial support for the basic needs.
Special thanks also go to friends, who helped us through suggestions, support and help throughout
the project.
iv
Table of Contents
Declaration.................................................................................................................................................... i
Dedication ................................................................................................................................................... iii
Acknowledgement ...................................................................................................................................... iv
List of Tables ............................................................................................................................................ viii
List of figures .............................................................................................................................................. ix
List of Acronyms ......................................................................................................................................... x
Abstract....................................................................................................................................................... xi
CHAPTER ONE: ........................................................................................................................................ 1
1.0 INTRODUCTION................................................................................................................................. 1
1.1 Background of the study ...................................................................................................................... 1
1.3 Problem statement ................................................................................................................................ 1
1.4 Objectives............................................................................................................................................... 2
1.4.1 General objectives .................................................................................................................2
1.4.2 Specific objectives .................................................................................................................2
1.4.3 Research questions ................................................................................................................2
1.5 Scope of the study.................................................................................................................................. 2
1.5.1 Content scope ........................................................................................................................2
1.5.2 Geographical scope ...............................................................................................................2
1.5.3 Time scope .............................................................................................................................2
1.6.1. To the government ...............................................................................................................2
1.6.2. To health workers. ...............................................................................................................3
1.6.3. To the developers .................................................................................................................3
CHAPTER TWO ........................................................................................................................................ 4
2.0 Literature review .................................................................................................................................. 4
2.1 Introduction ........................................................................................................................................... 4
2.2 Review of related literature .................................................................................................................. 4
2.2.1 District Health Information System and registration books ............................................4
2.2.2 Health Information Systems ................................................................................................5
v
2.2.3 Uganda Integrated Nutrition Information System ............................................................5
2.3 Gaps identified ...................................................................................................................................... 6
CHAPTER THREE:................................................................................................................................... 8
3.0 Methodology .......................................................................................................................................... 8
3.1 Introduction ........................................................................................................................................... 8
3.2 Research Design .................................................................................................................................... 8
3.2.1 Population ........................................................................................................................................... 8
3.2.3 Data Collection Methodology...............................................................................................9
3.3.1 Methodology ..........................................................................................................................9
3.3.2 Conceptual Design ..............................................................................................................10
3.4 System specification ............................................................................................................................ 12
3.4.1 Hardware Requirements ....................................................................................................12
3.4.2 Software Requirements ......................................................................................................13
s3.4.3 Functional Requirements..................................................................................................13
3.4.4 Non-Functional Requirements ...........................................................................................14
CHAPTER FOUR: ................................................................................................................................... 15
4.0 SYSTEM DESIGN AND IMPLEMENTATION ............................................................................. 15
4.1 Introduction ......................................................................................................................................... 15
4.2 System Design ...................................................................................................................................... 15
4.2.1 Process Design .....................................................................................................................15
4.2.2 Database Design ..................................................................................................................20
4.2.3 Interface Design ..................................................................................................................23
4.3 System Implementation ...................................................................................................................... 23
4.3.1 Login Page ...........................................................................................................................24
4.4. System Deployment ............................................................................................................................. 26
5.1 Introduction ......................................................................................................................................... 27
5.2 System Testing..................................................................................................................................... 27
vi
5.2.1 System Verification .............................................................................................................27
5.2.2 System Validation ...............................................................................................................30
5.2.2.1 User Acceptance Testing .................................................................................................30
5.3 System Evaluation ............................................................................................................................... 31
CHAPTER SIX: ........................................................................................................................................ 32
6.0 Ethical considerations and limitations .............................................................................................. 32
6.1 Introduction ......................................................................................................................................... 32
6.2 Ethical considerations ......................................................................................................................... 32
Ethical considerations ............................................................................................................................... 32
6.3 Limitations of the study ...................................................................................................................... 32
CHAPTER SEVEN: ................................................................................................................................. 34
7.0 CONCLUSION AND RECOMMENDATION ................................................................................ 34
7.1 Introduction ......................................................................................................................................... 34
7.2 Conclusions .......................................................................................................................................... 34
7.3 Recommendations ............................................................................................................................... 35
References .................................................................................................................................................. 36
Appendices ................................................................................................................................................. 37
Appendix 1: Questionnaire ...................................................................................................................... 37
Appendix 11: Interview Guide ................................................................................................................. 39
Appendix IV: ............................................................................................................................................. 41
vii
List of Tables
Table 1: Hardware Requirements ................................................................................................. 13
Table 2: Software Requirements ................................................................................................... 13
Table 3: Table for Users ............................................................................................................... 22
Table 4: Testing cases for Login, logout and Patient Registration Modules ............................... 29
viii
Figure 1:
List of figures
Incremental Method (https://www.guru99.com/what-is-incremental-model-in-sdlc-
advantages-disadvantages.html) ................................................................................................... 10
Figure 2: Level 0 DFD Nutrition Information System................................................................. 11
Figure 3 Level 1 DFD Nutrition Information System ................................................................... 11
Figure 4: System Architecture for Nutrition Information System ................................................. 12
Figure 5: Sequence Diagram for user .......................................................................................... 16
Figure 6: Use Case Diagram for Admin...................................................................................... 17
Figure 7: Use Case Diagram for user ......................................................................................... 18
Figure 8: State Diagram for adding a patient .............................................................................. 19
Figure 9: ER Diagram for Nutrition Information System ............................................................ 20
Figure 10: Object Class Diagram for Nutrition Information System.4.2.2.3 Data Dictionary .... 21
Figure 11: Interface Design.......................................................................................................... 23
Figure 12: Login Page4.3.6 chart page ........................................................................................ 24
Figure 13: bar graph page .......................................................................................................... 25
ix
List of Acronyms
NITWG……………….………………National Nutrition Information Technical Working Group
NIS………………………………………………………………......Nutrition Information System
DHIS……………………...…………………………………...District Health Information System
HMIS…………………………………………………… Health Management information system
VHT…………………………………………………………………………. Village Health Team
FSMNS………………………….………………Food Security and Nutrition Monitoring System
OTP/SFP………. ……..Outpatient Therapeutic Programme/ Supplementary Feeding Programme
IPC.……………………………...…………………………………Integrated Phase Classification
NIWG ……………………….....……………………….... Nutrition Information Working Group
M&E…………………………………………………………………...Monitoring and Evaluation
SAM …………………………………………………………………...Severe Acute Malnutrition
MAM………………………………………..……………………...Moderate Acute Malnutrition
MoH……………………………………..……………………………………. Ministry of Health
HSSP…………………………………………………………………Health Sector Strategic Plan
WHA……………………………………………………………………. World Health Assembly
WHO .…………………………………………………………………World Health Organisation
UINIS……………………………………………Uganda integrated nutrition information system
DBMS……………………………………………………………...Database Management System
x
Abstract
This research paper examined the challenges faced in managing nutritional information at Arua
Regional referral hospital. A survey was conducted to understand problems with the current system
and gather system requirements. Related literature was reviewed to identify the related existing
systems. A computer software application was designed and tested to facilitate the computerized
processing patient’s information. Using PHP, HTML, CSS, Bootstrap and MySQL. A few
challenges were encountered during the development of the system which included the following
not limited to; limited financial resources, lack of hardware support, limited time over scope and
limited expertise staff or personnel. User’s feedback will help us to incorporate an interaction
regionally with other health facilities and send notification messages to users especially nurses
when time for administering drugs approach. In conclusion, the system has made the manager’s
job less stressful by cutting down the time and effort spent on manual nutrition information
preparation and processing.
xi
CHAPTER ONE:
1.0 INTRODUCTION
1.1 Background of the study
A nutrition information system (NIS) delivers a range of services to the community and record
activities for reporting purpose and can be used to generate important data. It is used globally to
continuously collect, analyse and interprets nutrition-related data for making timely and effective
decisions to improve the nutritional health of the population. (Open.educ, 2018)
In Ethiopia for example according to Lemma (2013), the National Nutrition Information System has
been strengthened as part of the 2008-2013 National Nutrition Programme, which was updated for
2013-2015. The Health Extension Programme has ensured that NIS is widely recognized by all
partners as the source of reliable information which serves Emergency Nutrition Coordination Units
of the Ministry of Agriculture established at national and regional level13 in Ethiopia (Lemma, 2013).
This progressively reduced the duplication in data collection and ensured optimized sharing and use
of available information (Lemma, 2013).
In Uganda, the integrated nutrition information system (UINIS). Reported that Health Management
Information System (HMIS) Uganda, the official routine reporting system of the Ministry of Health
Uganda, involves the paper-based collection and compilation of data at the district level. The district
level data is entered into MS Access and Epi-Info at the national level. (MoH, 2010)
At the nutritional department of Arua regional referral hospital the current system for recording mal
nutritional information is paper-based, where data was captured from patients by health workers and
filled in pediatric inpatient medical record form, this data is then filled in nutrition form which is later
recorded in Uganda integrated nutrition information system records book.
1.3 Problem statement
The challenges of the current system includes storage problems leading to loss of data, data duplication
and inconsistence, and difficulty in retrieving data which has caused delays in decision making , high
costs of buying papers.
The problems raised necessitated a computerized system that can solve the above problems. The
proposed system can solve the above challenges by creating a centralized database that will reduce
data duplication and ensures consistence of data.
1
1.4 Objectives
1.4.1 General objectives
To design and test a Nutrition Information System for Arua regional referral hospital.
1.4.2 Specific objectives
1. To identify the challenges facing the existing system
2. To analyze the requirements needed to develop a computerized NIS
3. To design and test a nutrition information system.
1.4.3 Research questions
1. What system is currently being used for data recording and storage in Arua Regional Referral
Hospital?
2. What are the challenges being faced when using the existing system?
3. What requirements need to be gathered for the design and testing of a nutrition information
system?
1.5 Scope of the study
1.5.1 Content scope
In the content scope; the NIS was designed and tested with three modules namely Administrator,
Doctor, Nurse, Nutritionist combined as Users and reports, each with a distinct functionality.
Administrator module provides all the privileges in the functionality of the system, also capturing the
details of the administrators. User module captures all the user details.
1.5.2 Geographical scope
The geographical scope is Arua district
1.5.3 Time scope
The research started from August 2018 and was scheduled to end by December 2018.
1.6. Significance of the study
1.6.1. To the government
This project provides accurate information about malnutrition to the government to enable it plan and
budget well for the nation.
2
It makes it easy for the government and non-governmental agencies to analyze and monitor the rate of
malnutrition in Arua and the surrounding communities.
1.6.2. To health workers.
The system provides a tool to collect, analyze and store data and information for future use in informed
decision making for health workers in the nutrition department.
1.6.3. To the developers
The system leads us to the award of bachelor’s degree in information systems.
It helps us to gain skills and broaden our knowledge in system development, implementation and
project management.
3
CHAPTER TWO
2.0 Literature review
2.1 Introduction
This chapter provides the review of literature that is related with the system designed and comprises
of two sections; the first section describes the review on method, equipment, and technology.
2.2 Review of related literature
According to Wysocki& Krishnamurthi (1990), Nutrition information systems are an essential
component of national investment programs aimed at reducing the incidence and prevalence of
malnutrition in Asia. Yet the status of nutrition information in Asia remains problematic at the
regional, national, sub national, and community levels. It is therefore crucial to clearly identify the
information required to support effective design and management of country programs, and to build
the capability needed for generating and using this information. The UNICEF Information Strategy
(2018-21) has laid out a typology of systems and analyses for generating action, stressing that progress
requires reliable information, actual decisions, and their implementation on this basis (Wysocki,
1990).
2.2.1 District Health Information System and registration books
According to Titus, Rebecca , &,Shishay, (2013), South Sudan nutrition actors noted challenges of
nutrition information during emergencies and the need for a coordinated, validated NIS. Significant
and important changes were then made to validation of SMART surveys, Outpatient Therapeutic
Programme/ Supplementary Feeding Programme (OTP/SFP) reporting harmonization, Integrated
Phase Classification (IPC) and Food Security and Nutrition Monitoring System (FSMNS).
Improvements have been made and maintained. There are efforts to integrate the NIS into the District
Health Information System (DHIS) and Health Management information system (HMIS). Currently,
nutrition information reporting formats, registration books and other tools are being developed and
finalized in consultation with the Nutrition Information Working Group (NIWG). Nutrition
information is then shared with the M&E Department of the Ministry Of Health (Titus, Rebecca, &
Shishay, 2014)
Lucy, Louise , &, Veronica (2014) reports that, the Center for disease Control and prevention (CDC)
evaluation reviewed 11 key nutrition indicators routinely collected through the District Health
Information System: underweight, stunting, and vitamin A supplementation, iron folate
supplementation, treatment of severe acute malnutrition (SAM), treatment of moderate acute
4
malnutrition (MAM), deworming, growth monitoring, early breastfeeding initiation, exclusive
breastfeeding and micronutrient powder supplementation. Key challenges highlighted were as
follows: The same indicator was collected in more than one form (for example Ministry of Health 711
for Child Health and Ministry of Health 713 Nutrition Monthly Monitoring) and used different age
categorizations, classifications and reporting rates. Health facility stunting data were significantly
different from survey data. An estimated 10% of the facilities had information on stunting at the time
of the review; low reporting/poor data quality was mainly linked to limited access to height boards,
lack of time and staff for measurement, and skewed age distribution of children presenting at the health
Centre (Lucy , Louise , & Veronica , 2013).
Information systems for nutrition have three main functions. They measure changes in the nutrition
status of vulnerable people, namely children and women, they track progress in the implementation of
actions and they help to prioritize response. Reliable monitoring of progress, evaluation of outcomes
and demonstration of results are core functions for countries participating in the SUN Movement. SUN
countries are aiming to meet by 2025 the six targets agreed at the World Health Assembly (WHA) in
May 2012. Many countries have recently revised their national goals and are establishing robust
information systems to measure their progress towards the WHA agreed targets (Mayaki, 2014).
2.2.2 Health Information Systems
In the health report (2008) published by World Health Organization (WHO) Health Information
Systems serve multiple users and a wide array of purposes that can be summarized as the generation
of information to enable decision-makers at all levels of the health system to identify problems and
needs, make evidence-based decisions on health policy and allocate scarce resources optimally. Data
is collected manually from different sources and used for multiple purposes at different levels of the
health care system. Individual level data about the patient's profile, health care needs, and treatment
serve as the basis for clinical decision-making. Health care records provide the basis for sound
individual clinical care. Problems can arise when health workers are overburdened by excessive data
and reporting demands from multiple and poorly coordinated subsystems. Public health surveillance
brings together information from both facilities and communities with a focus mainly on defining
problems and providing a timely basis for action (WHO, 2008).
2.2.3 Uganda Integrated Nutrition Information System
5
The Uganda integrated nutrition information system (UINIS). Reported that Health Management
Information System (HMIS) Uganda, the official routine reporting system of the Ministry of Health
Uganda, involves the paper-based collection and compilation of data at the district level. The district
level data is entered into MS Access and Epi-Info at the national level. The HMIS collects some
nutritional indicators, including vitamin A supplementation and de-worming coverage by district, low
birth weight rates, the number of severe acute malnutrition cases and cases of anemia. Additionally,
under the Health Sector Strategic Plan (HSSP) III over 45 indicators are collected annually for detailed
monitoring and evaluation of interventions in the health sector (Health, 2007). However, none of the
indicators collected concern nutritional status or services. Population-based surveys: Among other
national institutions empowered to collect and analyze nutrition related data (MoH, 2010).
In the same concept paper, UINIS reported that more recently, a pilot sentinel-type surveillance system
was set by UNICEF and the District Health Office in Karamoja region. The first round of data
collection was conducted in November 2009. Depending on the results and lessons learned the
approach could be extended to other regions with the view to supplement the existing data collection
of nutritional indicators. Additionally, “a rapid short message service” (SMS) model was also tested
by UNICEF and partners in the Acholi region. This system enables a rapid and more comprehensive
detection referral and follow up for cases of severe malnutrition. The SMS model could also potentially
be scaled up (Health, 2007)
According to the data given by the health workers from nutrition department Arua regional referral
hospital shows that the system that is used to record patients’ data with mal-nutritional cases was
paper-based system where data was captured from patients by health workers and filled in a MHOUMSP pediatric inpatient medical record form, these data was then filled in nutrition form which was
later recorded in Uganda integrated nutrition information system records book
2.3 Gaps identified
In South Sudan, the use of registration books for data capture and storage necessitates the need to
computerize the system of data capture and storage in order to reduce data duplication and
inconsistence (Titus, Rebecca, & Shishay, 2014). The proposed system will address the challenges
mentioned above by creating a central database in order to computerize the process.
6
Arua regional referral hospital has a paper-based reporting format where charts and graphs are drawn
manually and many times not accurate enough according to the Nutritionist, the proposed system is
able to accurately generate reports automatically in form of graphs basing on data analysis.
The health management information system, patient data from the district level is submitted to the
ministry of health system in paper-form, however, the proposed system will capture and store data in
a database which can easily be retrieved for decision making and other purposes.
7
CHAPTER THREE:
3.0 Methodology
3.1 Introduction
This chapter describes research design involving the target population, sampling technique and data
collection methods to be used to achieve the objectives of the proposed study and describes the design
methodology which includes the incremental method and the conceptual design and further describes
the ethical considerations and limitations of the system.
3.2 Research Design
Research Design refers to the overall strategy that you choose to integrate the different components of
the study in a coherent and logical way, thereby, ensuring you will effectively address the research
(Trochim, 2006).
3.2.1 Population
Population refers to any group of institution, people or objects that have common characteristics
(Ogula, 2005). The study population will involve the 20 health workers in the Nutrition department of
Arua referral hospital who offer to provide information at the time data will be collected.
3.2.2 Sampling
Sampling is the process of selecting a few from a bigger group to become the basis of estimating or
predicting a fact, a situation or outcome regarding the bigger group (kumar, 2005). A sample of 5
health workers will be chosen at random from the Nutrition department with different roles for
instance Doctors, Nurses, and Nutritionists from whom data will be collected as a representative of
the population. The team used Simple Random Sampling (S.R.S) technique to obtain samples from
our target population which were the health workers at Nutrition Department of Arua regional
referral hospital because It is a fair way to select a sample from a population, since each member has equal
opportunities to be selected.
By Sloven’s formula of S.R.S,
Sample size,
𝑁
𝑛 = 1+𝑁(𝑒 2 )
8
Where;
N is population of 20 staffs, e = 0.03 error margin.
Sample size of approximately 7 health worker representatives will be selected, We used Simple
Random Sampling technique because it is straight forward, unbiased and easy to use.
3.2.3 Data Collection Methodology
3.2.3.1 Interviews
Interview is the verbal conversation between two people with the objective of collecting relevant
information for the purpose of research (kumar, 2005) We had a face to face interaction with the in
charge of the Nutrition Department on how they manage patients that is registering the patients with
unique identifiers, recording patient information, retrieving and report generation. She said there are
challenges they are facing such as difficulties in retrieving specific information, creating reports and
it is hard to manage large sums of data in books effectively.
3.2.3.2 Document review
According to (Bowen, 2009) document review is the way of collecting data by reviewing the existing
documents. The documents may be internal to an organization or may be external.
The researchers the In-charge of the Nutrition Department for the previous and current data reports
regarding their Nutrition Information System so as to get the required information for the proposed
study.
3.3 Design Methodology
3.3.1 Methodology
System development methodology refers to the framework that is used to structure, plan and control
the processes of development of an information system (kumar, 2005)
Incremental method
Incremental method of development was used to design the system. In incremental model the whole
requirement is divided into various builds. Multiple development cycles take place here. Cycles are
9
divided up into smaller, more easily managed modules. Each module passes through the requirements,
design, implementation and testing phases.
Using incremental method, the team broke the system into smaller, more easily managed modules that
was developed, tested and implemented one at a time. For example, home page module, patient
module, treatment module, nurse and doctor module which passed through the requirements, design,
and implementation and testing phases until the final version of the system was developed. Incremental
method was used because; it generates working software quickly and early during the software life
cycle, more flexible-less costly to change scope and requirements, easier to test and debug during a
smaller iteration, in this model, users can respond to each build, lowers initial delivery cost and easier
to manage risks because risk pieces are identified and handled during each iteration.
Figure 1: Incremental Method (https://www.guru99.com/what-is-incremental-model-in-sdlcadvantages-disadvantages.html)
3.3.2 Conceptual Design
This section describes how the system is represented inform of diagrams and these include the Data
Flow Diagrams and the System Architecture.
3.3.2.1 Data Flow Diagram
Data flow diagram is graphical representation of flow of data in an information system. It is capable
of depicting incoming data flow, outgoing data flow and stored data.
10
3.3.2.1.1 Level 0 DFD Nutrition Information System
Figure 2: Level 0 DFD Nutrition Information System
3.3.2.1.1 Level 1 DFD Nutrition Information System
Figure 3 Level 1 DFD Nutrition Information System
11
3.3.2.1 System Architecture
A system architecture or systems architecture is the conceptual model that defines the structure,
behavior, and more views of a system. An architecture description is a formal description and
representation of a system, organized in a way that supports reasoning about the structures and
behaviors of the system.
A system architecture can comprise system components, the expand systems developed, that will work
together to implement the overall system. There have been efforts to formalize languages to describe
system architecture. Collectively these are called architecture description languages (muller, 2012)
System Architecture for Nutrition Information System
Figure 4: System Architecture for Nutrition Information System
3.4 System specification
After analyzing the data collected, requirements are formulated and grouped as Hardware, Software,
Functional, and Non- Functional Requirements.
3.4.1 Hardware Requirements
Item
Specification
Processor
Intel Core 2.4 GHz or above
Memory
2GB RAM
12
Hard Disk
80GB (including 20GB for Database Management System)
Display
800 x 600 colors (1024 x 768 High color- 16 bit Recommended)
Cache Memory 128 KB
Table 1: Hardware Requirements
3.4.2 Software Requirements
Item
Specification
Operating System
Windows 7, 8, 8.1, 10,Linux and mac
Browser
Mozilla Firefox version 50 and above, opera,chrome
Front end tools
HTML, CSS, Bootstrap
Back end Tools
PHP
Development environment
Notepad , Bracket, Sublime
Server
XAMPP Server (Apache and MySQL)
Table 2: Software Requirements
s3.4.3 Functional Requirements
The goal of functional requirement is to determine the behavior of system for “Nutrition Information
System” in terms of functionality.
The following are the functional requirements of the Nutrition Information System (NIS):
User Registration Management: The system authenticates all users of the system. The system allows
users to login in the system, the system validates user's login, and the user can restore password if
forgotten.
Login: The system can be accessed by the authorized user who is a valid user. The authorized user
must use valid username and password to login to the system. There is validation on username and
password that is input. The system is able to deny the invalid user login to the system
Users Maintenance: The system stores the user’s information that includes the username and password
for login purpose. Admin does the entire basic maintenance like add new user, update their profile,
search their record through key words, and print reports.
13
Patient Management: The system adds, updates, searches and deletes patients.
Generate reports: the system generates reports inform of charts and graphs.
3.4.4 Non-Functional Requirements
In systems and requirements, a non-functional requirement is a requirement that specifies criteria that
can be used to judge the operation of a system, rather than specific behaviors. This should be contrasted
with functional requirements that define specific behavior or functions. The plan for implementing
functional requirements is detailed in the system design. The plan for implementing non-functional
requirements is detailed in the system architecture.
The following are the expected non-functional requirements of the Nutrition Information System.

Performance Requirement: NIS serves to accommodate the huge amount of data and requests
for access to the server from a large number of users. The system must be able to operate under
the stress of multiple processing of patients records.

Safety Requirement: The database of "NIS" is located in a special secure server and backups
to other servers directly at specific times to avoid loss and damage data.

Reliability Requirement: NIS provides accurate and reliable information about patients, thus
ensuring success and adoption of the system as accurate information source.

Availability Requirements: NIS is available at all times that is limited down time.

Robustness: The system is able to run with minimal breakdown and failures and stores patients
‘data in a database.

User friendly: The system gives users a user-friendly and easy to learn capabilities and
retrieves all the registered patients and users in the system.
14
CHAPTER FOUR:
4.0 SYSTEM DESIGN AND IMPLEMENTATION
4.1 Introduction
This chapter describes the actual system design and its implementation. The system was transformed
from user requirement into a workable product. A lot of design features were taken into consideration
including interface design, component design and database design. After design, the actual coding
(implementation) was done. The purpose of system implementation is to make sure that the correct
application is delivered to the users.
4.2 System Design
4.2.1 Process Design
The Process Design basically describes the sequence diagrams, use case diagrams and state diagrams
as described below.
4.2.1.1 Sequence Diagram
Sequence diagrams show a detailed flow for a specific use case or a part of a specific use case.
They show the calls between the different objects in their sequence and different calls to different
objects (Bell, 2004)
15
(Bell, 2003).
4.2.1.1.1 Sequence Diagram for user
Figure 5: Sequence Diagram for user
4.2.1.2 Use Case Diagram
Use case diagram describes a set of interactions between an actor and the system, in order to achieve
a particular goal, prompted by some kind of triggering event (Gibson, 2007). It describes the
behavior of the system from the user’s standpoint. It provides a graphic description of who will use a
system and what kinds of interactions to expect within that system.
16
4.2.1.2.1 Use case Diagram for Admin
Figure 6: Use Case Diagram for Admin
17
4.2.1.2.2 Use case Diagram for Client
Figure 7: Use Case Diagram for user
18
4.2.1.3 State Diagram
A
state
diagram
is
used
to
describe
the
System.
1.2.1.3.1
State diagram for adding a patient by a user
Figure 8: State Diagram for adding a patient
19
behavior
of
Nutrition
Information
4.2.2 Database Design
The Database was designed to solve the problem of capturing and retrieving information. These were
the main problems that lead to errors in manual system and create difficulties in accessing the stored
information. The DBMS used is MySQL and this section includes details of the database design. The
Conceptual and Physical Database Design and the data dictionary are described below.
4.2.2.1 ERD
An entity-relationship diagram (ERD) is a graphical representation of an information system that
shows the relationship between people, objects, places, concepts or events within that system. An
ERD is a data modeling technique that can help define business processes and can be used as the
foundation for a relational database. Entity Relationship Diagrams are useful for organizing data
that can be represented by a relational structure.
Figure 9: ER Diagram for Nutrition Information System
20
4.2.2.2 Object Class Diagram for Nutrition Information System
Object
class
diagram
shows
the
detailed
state
of
Nutrition
Information
System
System at a point in time. The diagram shows the system's classes, their attributes, operations or
methods, and the relationships among objects.
Figure 10: Object Class Diagram for Nutrition Information System.
21
4.2.2.3 Data Dictionary
The Data Dictionary describes all these elements of a system. It is an electronic glossary of
items. It defines each element encountered during the analysis and design of a new
system. The following are the entities and their structures:
Users
Table Name
Users
Description
This table stores information about the users
Primary Key
user_id
Foreign Key
usertype_id
Sr. No
Field Name
Data Type(Size)
Constraints
Description
1
user_id
INT(11)
PRIMARY
It stores User id
KEY,
NOT
NULL,
AUTO
INCREMENT
2
usertype_id
INT(11)
NOT NULL
It stores User type id
4
first_name
VARCHAR(50)
NOT NULL
It stores User first name
5
last_name
VARCHAR(50)
NOT NULL
It stores User last name
6
Email
VARCHAR(200) NOT NULL
It stores User email
7
Password
VARCHAR(100) NOT NULL
It stores User password
8
Phone
VARCHAR(15)
NOT NULL
It stores the contact
10
Address
VARCHAR(200) NOT NULL
It stores the address
11
City
VARCHAR(100) NOT NULL
It stores city
12
State
VARCHAR(100) NOT NULL
It stores state
13
created_date
DATETIME
NOT NULL
It stores Created date
14
updated_date
DATETIME
NOT NULL
It stores Updated date
15
Status
VARCHAR(1)
NOT NULL
It stores status
Table 3: Table for Users
22
4.2.3 Interface Design
This interface presents the dashboard
Figure 11: Interface Design
4.3 System Implementation
This section describes the detailed implementation of the Nutrition Information System (NIS). It
includes a detailed description of the user interfaces developed and the tools used to develop them.
The GUI was developed using HTML, CSS and Bootstrap.
23
4.3.1 Login Page
This page allows the user to login the system using valid username and password. Here a user can also
sign up he/she does not have an account before and this page also allows the user to trace for forgotten
password.
Figure 12: Login Page4.3.6 chart page
This page displays number of admissions in year inform of a bar graph
24
Figure 13: bar graph page
25
4.4. System Deployment
System deployment refers to delivery, installation and testing of computer system to put it into a state
of operational readiness. (business dictionary, 2018)
The system will be deployed using the parallel adoption method of system deployment.
Parallel Adoption is the method of hardware or software migration that involves using the existing and
the new systems simultaneously until the implementation is just to be complete and satisfactory.
During the transition, users work with both systems as they gradually learn the new software. Parallel
method is user friendly. However, there is generally some duplication of effort as, for example data
must be entered into both systems that can lead to data quality issues. (Rouse, 2014)
The above method was chosen because;

It allows results to be compared to ensure the new system without errors.

It allows training of staff and gain confidence in the system.
26
CHAPTER FIVE:
5.0 System testing and evaluation
5.1 Introduction
The objective of every information systems development is making it applicable to solve the problem
for which it was designed. Before this is done, users should accept that the system indeed solves the
problem or simplify work for them. This is the main reason behind system testing. The Nutrition
Information System was tested to see if:

The system meets its requirements

The system performs in accordance with the users’ expectations
5.2 System Testing
According to (laycock, 2010), System testing is a type of testing conducted on a complete, integrated
system to evaluate the system’s compliance with its specified requirements. System testing was done
during and after the system development. This was done in two ways namely system verification and
system validation.
5.2.1 System Verification
According to (IEEE/ISO, 2015), system verification is the confirmation through the provision of
objective evidence, that specified requirements have been fulfilled. The team tested the system in three
ways namely unit testing, integration testing and system testing.
5.2.1.1 Unit Testing
According to (Dustin, 2002) unit testing involves testing of an individual software component or
module. It is typically done by the programmer and not by testers, as it requires a detailed
knowledge of the internal program design and code. It may also require developing test harnesses.
Unit testing was carried out on individual modules of the system, for example on the
administrator’s page, we tested the booking features to check whether the admin can search, activate
or inactivate bookings depending on the need. We tested the login page by entering both wrong and
correct emails and passwords of users and the login page was authenticating. We again tested for user’s
logout as well. All these are illustrated in the table below.
27
System
Nutrition Information System
Sub System
Login
Test Case name
Login Session Start
Precondition
•
User must have a username and a password
•
Enter the correct username
•
username ‘nutrition’’ must exist in the database
with password ‘123’
Step
Pass
Fail
Enter username ’nutrition’ and
Expected System Response
Redirect to the dashboard
Password ‘123’
Enter username
‘nis’
and
User not found in the database. Wrong
Password ‘password’
username and or password
Post condition
Session started success full
Sub System
Logout
Test Case name
Login destroy
Precondition
User object must exist
User object must exist
Session must be Created
Step
Pass
Fail
Press Logout button
Post condition
Expected System Response
Redirect to login page
Session destroyed
28
Sub System
Patient Registration
Test Case name
Add Patient to the system
Precondition
The user must have logged in.
Step
Pass
Fail
Fill and submit patient form
Fill the patient registration form
Post condition
Patient records have been successfully submitted
Sub System
Patient Registration
Test Case name
Display patient records
Precondition
The user must have added a patient to the system
Step
Pass
Fail
Click the button view.
Post condition
Redirect to update page
Patient records inserted will be displayed
Table 4: Testing cases for Login, logout and Patient Registration Modules
29
5.2.1.2 Integration Testing
This is the testing of all integrated modules to verify the combined functionality after integration.
Modules are typically code modules, individual applications, client and server applications on
a network, etc. This type of testing is especially relevant to client/server and distributed systems
(Maurro, 2007). Integration Testing follows unit testing and precedes system testing.
Individual
modules
that
were
individually
tested,
integration
testing
was
carried
out to ensure that combined modules were functioning as expected. We employed integration testing
in such a way where the patients’ registration module was connected to discharge module in such that
the patient ID that was used in registration is the same ID when discharging the patient. Patient
Registration was also connected to mortality module such that incase the patient died his/her ID can
be used when filling the mortality form. We tested and found out that the modules were working
properly.
5.2.1.3 System Testing
Testing conducted on a complete, integrated system to evaluate the system's compliance with its
specified requirements. System testing falls within the scope of black box testing, and as such,
should require no knowledge of the inner design of the code or logic (laycock, 2010).
The system was able to capture, store, update and retrieve patient records added by the
user. The system was able to generate reports inform of graphs. The system generated a bar graph
showing number of patients admitted in a given period of year. The users were able to login to the
system using the correct credentials and add and update patient details.
5.2.2 System Validation
System validation is the assurance that a product, service, or system meets the needs of the users and
other identified stakeholders (Buede, 2009). System validation is majorly concerned with User
Acceptance Testing.
5.2.2.1 User Acceptance Testing
This is the type of testing normally done by the end users. It is the key factor for the success of any
system. The system under consideration is tested for user acceptance by constantly keeping the records
of applicants and making changes to the details whenever required. We gave the system to one of the
end users to interact with where he thanked us for the job well done as the system can solve the
30
challenges of using a paper-based system. Challenges like duplication of data, high costs of purchasing
papers and stationery among others.
5.3 System Evaluation
System evaluation is the process by which a system or components are compared against requirements
and specification through testing (Hopkins, 2009). After conducting the four levels of testing, the
system was believed to have achieved more than eighty-five percent of the specification. The
evaluation of the system was done by the developers and a few staff of Arua Referral Hospital from
the department of nutrition.
31
CHAPTER SIX:
6.0 Ethical considerations and limitations
6.1 Introduction
This chapter describes the ethical considerations to take into account during the development of the
system and limitations of the study.
6.2 Ethical considerations
Ethical considerations refer to an accumulation of values and principles that address questions of what
is good or bad in human affairs. (GRADY, 2010). We included the following ethical considerations:
Ethical considerations
i.
Authorized access to data: the researchers will seek permission from the authority before
accessing any form of data for the research project.
ii.
Privacy of patient data: In our search for information from the health workers, we assure them
of privacy on the patient data since we are going to only use it for system development without
giving it out to other people.
iii.
Falsification and fabrication of data: the researchers assure that the respondents were not
tricked nor bribed to give data.
iv.
Protection of Intellectual Property: “Give proper credit for intellectual property . . .
Specifically, one must not take credit for other’s ideas or works . . .” (ACM Code of Ethics
Principle 1.6). Proper credit has been attributed to other people whose idea has been integrated
into the system and the report. No commercial software’s source code will be used in any way
while developing the proposed system and we therefore acknowledge all those whose
resources (materials) will be use during the study.
v.
Quality: We strive to achieve the highest quality in both process and product (ACM Code of
Ethics Principle 2.1). Our proposed system interface will be user friendly and easy to use for
all the medical workers
6.3 Limitations of the study
The following are the limitations towards achieving the objectives of the study;
1. Lack of trust by the data providers. We fear that patient data might be critical and health workers
might force to hoard some information.
2. Under-staffing/limited personnel to provide us with the necessary data, this is because the few staff
available may be busy attending to patients.
32
3. Power blackouts. This makes our research difficult whereby power in case goes off and we need
some information to be searched on the internet or documented on the laptops, this will put our
work to a standstill.
4. Time constraints; the time allocation was not adequate for developing the system that made the
project scope to be narrowed to suit the available given time
5. Lack hardware support like a high speed computer in processor speed which will slow the
development or coding phase as far as time is concerned.
6. Lack of technical ability to interact by the users, during the requirements gathering the users did
not know how to express fully their user experiences with the current system.
33
CHAPTER SEVEN:
7.0 CONCLUSION AND RECOMMENDATION
7.1 Introduction
The final chapter summarizes the results that have been reached from requirement gathering, analysis,
modeling, implementation, integration and testing of the Nutrition Information System (NIS) and
provides recommendations for the next development activities to the developers of system.
7.2 Conclusions
While conducting this project from start to end was a very challenging but rewarding exercise as it
required us to apply knowledge gained from various theoretical course units to a problem in the
industry. Furthermore, facing tasks never taught in class provoked us to learn more and hence has led
to an improvement in our professional skills apart from academic achievements. The development of
the software product repeated mainly through three phases which were the Requirements gathering
phase, Analysis and Design phase and testing phase.
Through systematic testing, various improvements were identified and some were worked on
meanwhile others will be included in future versions of the product. These improvements include the
following:

A further enhancement in the user interface to improvement usability for special need users.

Improvement of color schemes and styles to match organization taste and information display.

The remote access of the system to improve on usability, availability, reliability and
accessibility.

Improve data and information security to protect patients’ data.
34
7.3 Recommendations
As the researchers and developers of Nutrition Information System, we recommend that any further
development of this system should encompass on;

Feedback reply: The future version should provide the means of the admin to be able to reply
the user’s feedbacks.

Integration; the system should be able to interact regionally with other health facilities that is
integrating it into a single system for all for the hospitals.

Notification; in future the system should be able to alert and send notification messages to
users especially nurses when time for administering drugs approach.
35
References
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Dustin, E. (2002). Effective software testing.
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Appendices
Appendix 1: Questionnaire
A QUESTIONNAIRE FOR
THE
HEALTH
WORKERS
AT
THE
NUTRITION
DEPARTMENT OF ARUA REFERRAL HOSPITAL
We are conducting a research study on “Designing and Testing of a Nutrition Information System.”
As students taking an information systems capstone final year project, you are useful to the success of
this project. Therefore, you are kindly requested to respond to the items in the section below. Your
input in this study is highly appreciated and will be used purely for the project purposes only.
In case you need any further information, or if you have any complain regarding this project, contact
the researchers on 0774808771/0775064180.
Thank you.
SECTION I
For demographic purposes, please check the boxes that are appropriate and also write where necessary.
Age: …………….
Gender: Male
Female
Role at the Department:
………………………………………………………………………………………………………
SECTION II
Please tick in the boxes that are appropriate
1. When capturing and storing patient data which of the following systems do you use?
37
Paper-based system partially
computerized (Microsoft Excel) system
Fully Computerized System
2. What are the possible challenges of using a paper-based system?
Challenges
SD
D
A
SA
Lack of storage space
Prone to damage
Difficult to retrieve data
Duplication of data
Editing problems
Strongly Disagree (SD), Disagree (D), Agree (A), Strongly Agree (SA)
Others specify
…………………………………………………………………………………………………
……………………………………………………………………………………………
3. Which type of patient data is captured by your system?
…………………………………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………………………………………………………
………………………………………………………………………………………
38
Appendix 11: Interview Guide
INTERVIEW GUIDE FOR THE HEALTH WORKERS AT THE NUTRITION
DEPARTMENT OF ARUA REFERRAL HOSPITAL
Finding out the existing system.
 Current system used to collect data
Identifying the challenges facing the existing system
 Challenges facing the existing system
 Disadvantages of the current system
 Vulnerabilities encountered while using the current system.
Analyzing the information needed in system.
 Data captured from patients
 The different forms filled about the patient.
 How the data about the patients is stored?
 Measures used to ensure security of patient’s data
39
Appendix 1II: Gantt Chart
40
Appendix IV: Proposed Budget
ITEM
ITEM NAME
PARTICULARS
AMOUNT(Ugshs)
NO.
1
Hardware
Lenovo
1. Laptop(PC)
2.4 GHZ processor speed
2. Processor
128 MB RAM (256 MB
3. Memory
Recommended)
4. Hard Disk
80 GB (including 20 GB for
1,200,000
database Management system)
2
Software
1. Operating System
Ubuntu
2. Database Management
MYSQL
25,000
System
3
10,000
Stationary
1. Papers
2. Pens
4
Data bundles
30,000
5
Miscellaneous
100,000
1,365,000
TOTAL
Table10: shows the proposed budget of designing and implementing a nutrition information
system
41