THE POLYTECHNIC
FACULTY OF APPLIED SCIENCES
DEPARTMENT OF COMPUTING AND INFORMATION TECHNOLOGY
MODULE NUMBER:
PRJ-400
MODULE NAME:
PROJECT 2
PROJECT REPORT:
DEVELOPMENT OF THE BANGWE ANTENATAL CARE MANAGEMENT
(BANCM) SYSTEM
SUBMITTED BY:
BLESSIUS NYIRENDA (BIT/16/SS/022)
+265991999158 / bnyirendah2@gmail.com/bit16-bnyirenda@mubas.ac.mw
IN PARTIAL FULFILLMENT FOR THE AWARD OF THE DEGREE OF BACHELOR OF
SCIENCE IN INFORMATION TECHNOLOGY
SUPERVISOR:
MS SARAH KHUDZE
Date of Submission
11th October, 2021
ABSTRACT
Antenatal care is the treatment women receive during the pregnancy period to make sure that
the woman and unborn baby are in a healthier condition. Globally, antenatal care is taken into
account since it is considered as the cornerstone for reducing children’s deaths and improving
maternal health. Currently, many health centres here in Malawi use a manual system in helping
expectant women in their antenatal care department. Bangwe Health Centre is not an exception.
This manual system has many challenges.
The project therefore, aimed at developing a system for Bangwe antenatal care that will be
used at Bangwe Health Centre to automate all the processes at the ANC department.
Several systems were reviewed and analyzed to see how other systems were. MPACSS,
EPMR, and WDCR were some of the systems that were reviewed in order for the developer
to come up with a system.
The system was developed using prototyping system development methodology under Rapid
Application Development (RAD) techniques whereby design and system implementation
were done concurrently until the final prototype was satisfied by the users of the system. The
following data collection techniques was used: existing documents analysis, interviews,
observation, and prototype evaluation.
Use Case diagram and Data Flow Diagram were used to analyse the system requirements
which were gathered when the developer was conducting the analysis. And the system
architecture under which the system will be running was the client server architecture. Entity
Relationship Diagram was used to model the actual physical database model.
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DECLARATION
I declare that BANGWE ANTENATAL CARE MANAGEMENT SYSTEM (BANCMS) is
my own work and that all sources I have used or quoted have been indicated and
acknowledged by means of complete references and that this work has not been submitted
before for any other degree at any other institution
Blessius Nyirenda
--------------------------------------------------------------------------------Full Name
-----------------------------------------------------------------------------------Signature
……………………………………………………………………………
Date
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CERTIFICATE OF APPROVAL
I the undersigned certify that this thesis represents the student’s own work and has been
submitted with my approval.
Supervisor: Ms Sarah Khudze
Cell phone: +265 994 44 75 88
Email: skhudze@poly.ac.mw
Date: _______________________________________________________
Signature: _______________________________________________________
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DEDICATION
I dedicate this project to my cousin who passed away while giving birth to her first child. She
was very supportive and caring; may her soul continue resting in peace. I also dedicate this
project to my parents who have always been there for me and financially supported me
during my four years of study at the college. They have encouraged, motivated me
throughout my life and I would not be where I am without them.
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ACKNOWLEDGEMENT
The author is very grateful to GOD ALMIGHTY for without His graces and blessings, this
study would not have been possible.
Immeasurable appreciation and deepest gratitude for the help and support are extended to the
following people who in one way or another have contributed in making this study possible.
My family for supporting me throughout my four years of college.
My supervisor Ms Sarah Khudze for the guidance, support and help she rendered to during
the development of the project. Her corrections were very helpful and they have helped
deliver the product today.
The projects coordinator Dr A. Taylor for the guidance and help she rendered to during the
development of the project. I really appreciate her guidance and time she spared for me to
accomplish the development of this project.
My classmates (both BIT and BIS). They have been really supportive throughout my four
years stay at the University both emotionally and academically. Without them I wouldn’t be
the person I am today; I consider them to be my second family.
A big gratitude goes to the Hospital in charge of Bangwe Health Centre Ms Mfundula for
welcoming me and giving me all the necessary information and feedback to develop the
system.
All workers (Nurses, Midwives, Clinicians, etc) of Bangwe Health Centre for welcoming me
and giving me all the necessary information and feedback to develop the system.
Finally, all pregnant mothers who spared their time and allowed me to interview them, I
would like to say thank you. The project would not be a success without their time,
information and feedback.
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ABBREVIATIONS
DOB
Date of Birth
PDF
Portable Document Files
BANCMS
Bangwe Antenatal Care Management System
ERD
Entity Relationship Diagram
HDD
Hard Disk Drive
RAM
Random Access Memory
CPU
Central Processing Unit
ANC
Antenatal Care
FANC
Focused Antenatal Care
MPACSS
Mobile Phone- Based Antenatal Care Support System
EPMR
Electronic Personal Maternity Records
WDCR
Women’s Digital Care Record
RAD
Rapid Application Development
DFD
Data Flow Diagram
ANCMS
Antenatal Care Management System
WHO
World Health Organization
UNICEF
United Nations International Children’s Emergency Fund
MNH
Maternal and Neonatal Health
HIV
Human Immunodeficiency Virus
AIDS
Acquired Immunodeficiency Syndrome
GUI
Graphical User Interface
EMRS
Electronic Medical Record System
DHO
District Health Officer
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SDLC
Systems Development Life Cycle
MUBAS
Malawi University of Business and Applied Sciences
BANCMS
Bangwe Antenatal Care Management System
LAN
Local Area Network
PHP
Hypertext Preprocessor
SQL
Structured Query Language
RDMS
Relational Database Management System
HTML
Hyper Text Markup Language
CSS
Cascading Style Sheet
WAMP
Windows, Apache, MySQL and PHP
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Table of Contents
ABSTRACT ............................................................................................................................................. i
DECLARATION .................................................................................................................................... ii
CERTIFICATE OF APPROVAL .......................................................................................................... iii
DEDICATION ....................................................................................................................................... iv
ACKNOWLEDGEMENT ...................................................................................................................... v
ABBREVIATIONS ............................................................................................................................... vi
LIST OF FIGURES .............................................................................................................................. xii
LIST OF TABLES ............................................................................................................................... xiv
CHAPTER 1. INTRODUCTION .......................................................................................................... 1
1.1.
Context of the Research .............................................................................................. 1
1.2.
Problem Statements ..................................................................................................... 2
1.4.
Project Objectives ....................................................................................................... 2
1.4.1.
Main Objective................................................................................................................ 2
1.4.2.
Specific Objectives ......................................................................................................... 3
1.5.
Project Justification ..................................................................................................... 3
1.6.
Ethical Consideration .................................................................................................. 3
CHAPTER 2. LITERATURE REVIEW ................................................................................................ 5
2.1.
Introduction ................................................................................................................. 5
2.2.
Antenatal Care ............................................................................................................. 5
2.3.
Health promotion and disease prevention ................................................................... 6
2.4.
Detection and treatment of existing diseases and conditions ...................................... 6
2.5.
Early detection and management of complications..................................................... 6
2.6.
Birth preparedness and compilation readiness ............................................................ 7
2.7.
Coverage of antenatal care .......................................................................................... 7
2.8.
Effective Antenatal care interventions ........................................................................ 7
2.9.
Review of the ANC Management systems ................................................................. 8
2.9.1.
Mobile Phone-Based Antenatal Care Support System (MPACSS) ................................ 8
2.9.2.
Electronic Personal Maternity Records (EPMR) ............................................................ 9
2.9.3.
Women’s Digital Care Record (WDCR). ..................................................................... 10
2.9.4.
Review of the proposed system..................................................................................... 11
CHAPTER 3. METHODOLOGY ........................................................................................................ 13
3.1.
Overview ................................................................................................................... 13
3.2.
System Development Approach ................................................................................ 13
3.3.
Data Collection Methods ........................................................................................... 14
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3.3.1.
Documents Analysis ..................................................................................................... 14
3.3.2.
Interviews ...................................................................................................................... 15
3.3.3.
Observation ................................................................................................................... 15
3.3.4.
Prototype Evaluation ..................................................................................................... 15
3.4.
Data Analysis ............................................................................................................ 15
3.5.
Process Analysis ........................................................................................................ 15
CHAPTER 4. REQUIREMENTS ANALYSIS .................................................................................... 16
4.1.
Functional requirements ............................................................................................ 16
4.2.
Non-functional requirements..................................................................................... 17
4.2.1.
Operational Requirements............................................................................................. 17
4.2.2.
Performance Requirements ........................................................................................... 17
4.2.3.
Security Requirements .................................................................................................. 17
4.2.4.
Usability Requirement .................................................................................................. 18
4.3.
Use Cases .................................................................................................................. 18
4.3.1.
BANCMS Use Case Diagram ....................................................................................... 18
4.3.2.
Use Case Descriptions .................................................................................................. 20
4.4.
Process Modelling and Data Flow Diagrams ............................................................ 28
4.4.1.
Context Diagram ........................................................................................................... 29
CHAPTER 5. SYSTEM DESIGN ........................................................................................................ 30
5.1.
Overview ................................................................................................................... 30
5.2.
Level 0 Data Flow Diagram ...................................................................................... 30
5.3.
Data Modelling and Entity Relationship Diagram (ERD) ........................................ 31
5.4.
System Architecture Design ...................................................................................... 32
5.4.1.
Page Layout .................................................................................................................. 33
5.4.2.
Messages ....................................................................................................................... 35
5.4.3.
Input Design .................................................................................................................. 35
5.4.4.
Output design ................................................................................................................ 36
5.5.
Database Design ........................................................................................................ 36
5.5.1.
Physical Entity Relationship Diagram (ERD)............................................................... 36
5.5.2.
Database Schema .......................................................................................................... 37
CHAPTER 6. SYSTEM IMPLEMENTATION AND TESTING ........................................................ 40
6.1.
Overview ................................................................................................................... 40
6.2.
Key System features of the BANCM system ............................................................ 40
6.2.1.
Adding a new patient .................................................................................................... 40
6.2.2.
Viewing patient details.................................................................................................. 40
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6.2.3.
Editing patient details.................................................................................................... 40
6.2.4.
Deleting a patient .......................................................................................................... 41
6.2.5.
Searching a patient ........................................................................................................ 41
6.2.6.
Accessing the system .................................................................................................... 41
6.3.
System construction .................................................................................................. 41
6.3.1.
PHP ............................................................................................................................... 41
6.3.2.
MYSQL......................................................................................................................... 42
6.3.3.
JAVASCRIPT AND JQUERY ..................................................................................... 42
6.3.4.
HTML and CSS ............................................................................................................ 42
6.3.5.
SUBLIME TEXT .......................................................................................................... 42
6.3.6.
MYSQL WORKBENCH .............................................................................................. 42
6.3.7.
PHPMYADMIN ........................................................................................................... 43
6.3.8.
EDRAW MAX.............................................................................................................. 43
6.4.
Coding ....................................................................................................................... 43
6.5.
System Testing .......................................................................................................... 43
6.5.1.
Blackbox testing............................................................................................................ 43
6.5.2.
Whitebox testing ........................................................................................................... 44
6.6.
Compatibility Testing................................................................................................ 44
6.6.1.
Operating System Compatibility ................................................................................... 44
6.6.2.
Web Browser Compatibility ......................................................................................... 44
6.7.
Testing levels............................................................................................................. 45
6.7.1.
Unit Testing .................................................................................................................. 45
6.7.2.
Integration Testing ........................................................................................................ 46
6.7.3.
System Testing .............................................................................................................. 46
6.8.
Tests and Tests results ............................................................................................... 46
6.9.
Deployment Plan and The Requirements needed for Successful Deployment ......... 49
6.9.1.
Deployment Plan ........................................................................................................... 50
6.9.2.
The Requirements Needed for Successful Deployment of the System. ........................ 51
6.10.
System Specifications ............................................................................................ 52
CHAPTER 7. CONCLUSION.............................................................................................................. 53
7.1. Discussion of Objectives ............................................................................................... 53
7.1.1. Objective One ..................................................................................................................... 53
7.1.2. Objective Two ..................................................................................................................... 53
7.1.3. Objective Three ................................................................................................................... 53
7.1.4. Objective Four .................................................................................................................... 54
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7.1.5. Objective Five ..................................................................................................................... 54
7.2. Experiences ................................................................................................................... 54
7.3. Challenges and Limitations ........................................................................................... 54
7.4. Recommendations ......................................................................................................... 55
REFERENCES ..................................................................................................................................... 56
APPENDICES ...................................................................................................................................... 58
Appendix A: Interview Questions......................................................................................................... 58
Appendix B: The Installation Process and Copying Files in Windows Operating System .................. 65
Appendix C: System Manual ................................................................................................................ 70
A) Nurse/ Midwife User Manual ......................................................................................... 71
B) Hospital Incharge Manual ............................................................................................... 77
C) The Administrator Manual .............................................................................................. 79
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LIST OF FIGURES
Figure 1: Architecture of MPACSS ........................................................................................... 9
Figure 2: Architecture of EPMR .............................................................................................. 10
Figure 3: Architecture of WDCR ............................................................................................. 11
Figure 4: System Prototype Methodology ............................................................................... 14
Figure 5: BANCMS Use Case Diagram .................................................................................. 19
Figure 6: BANCMS Context Diagram .................................................................................... 29
Figure 7: BANCMS Data Flow Diagram ................................................................................ 31
Figure 8: BANCMS Entity Relationship Diagram .................................................................. 32
Figure 9: System Architecture design ...................................................................................... 33
Figure 10: Interface design layout template for the login page ............................................... 33
Figure 11: Interface design layout template for the admin home page.................................... 34
Figure 12: Interface design layout template for the hospital incharge home page .................. 34
Figure 13: Interface design layout template for a Nurse/ Midwife home page ....................... 35
Figure 14: Physical Entity Relationship Diagram for the BANCM System ........................... 37
Figure 15: Integration testing diagram ..................................................................................... 46
Figure 16: WampServer Installation ........................................................................................ 66
Figure 17: Mozilla Firefox Installation .................................................................................... 67
Figure 18: phpMyAdmin login ................................................................................................ 68
Figure 19: phpMyAdmin homepage ........................................................................................ 68
Figure 20: phpMyAdmin import page ..................................................................................... 69
Figure 21: BANCMS login page ............................................................................................. 70
Figure 22: Nurse/ Midwife dashboard ..................................................................................... 71
Figure 23: Creating a New Patient ........................................................................................... 72
Figure 24: A form used to add a new patient into the system.................................................. 73
Figure 25: Edit feature. ............................................................................................................ 74
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Figure 26: Record problems page ............................................................................................ 74
Figure 27: Discharge page ....................................................................................................... 75
Figure 28: Discharged patients ................................................................................................ 76
Figure 29: Searching using surname ........................................................................................ 77
Figure 30: Search using phone number ................................................................................... 77
Figure 31: The hospital Incharge dashboard ............................................................................ 78
Figure 32: BANCMS general report ........................................................................................ 78
Figure 33: Admin settings tab .................................................................................................. 80
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LIST OF TABLES
Table 1: Use case 1 .................................................................................................................. 20
Table 2: Use case 2 .................................................................................................................. 21
Table 3: Use case 3 .................................................................................................................. 22
Table 4: Use case 4 .................................................................................................................. 23
Table 5:Use case 5 ................................................................................................................... 24
Table 6: Use case 6 .................................................................................................................. 24
Table 7: Use case 7 .................................................................................................................. 25
Table 8: Use case 8 .................................................................................................................. 26
Table 9: Use case 9 .................................................................................................................. 26
Table 10: Use case 10 .............................................................................................................. 27
Table 11: Use case 11 .............................................................................................................. 28
Table 12: Use case 12 .............................................................................................................. 28
Table 13: Patient schema ......................................................................................................... 38
Table 14: Patient_visits schema ............................................................................................... 38
Table 15:Materials_given schema ........................................................................................... 38
Table 16: Patient_next_visit schema ....................................................................................... 38
Table 17: Patient problems schema ......................................................................................... 39
Table 18: Patient treatment schema ......................................................................................... 39
Table 19: User’s schema .......................................................................................................... 39
Table 20: OS compatibility Testing ......................................................................................... 44
Table 21: Web browser compatibility Testing......................................................................... 44
Table 22: Test Plan Template .................................................................................................. 45
Table 23: Test 1 ....................................................................................................................... 47
Table 24: Test 2 ....................................................................................................................... 48
Table 25: Test 3 ....................................................................................................................... 48
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Table 26: Test 4 ....................................................................................................................... 49
Table 27: Test 5 ....................................................................................................................... 49
Table 28: Deployment plan template ....................................................................................... 51
Table 29: Recommended software specifications for BANCMS ............................................ 51
Table 30: Recommended hardware specifications for BANCMS ........................................... 52
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CHAPTER 1. INTRODUCTION
1.1.
Context of the Research
Antenatal care is the treatment women receive during the pregnancy period to make sure that
the woman and unborn baby are in a healthier condition. It is sometimes referred to as
pregnancy care or maternity care. Women are supposed to start antenatal care as soon as they
notice that they are pregnant. The midwife or doctor providing antenatal care checks the health
of the mother and the unborn baby, then gives useful information to help the mother to have a
healthy pregnancy. Information such as, advice about healthy eating and exercise, discussion
on options and choices during pregnancy, labour and health, answer any questions on any new
body development that may rise. Globally, antenatal care is taken into account since it is
considered as the cornerstone for reducing children’s deaths and improving maternal health.
Antenatal care reduces maternal and perinatal morbidity by identifying risks and preventing
and managing pregnancy-related or concurrent health problems. The expectant woman is
encouraged to visit any health facility of their choice starting from the first month of pregnancy.
Upon the first visit to a government health facility, the department of antenatal care gives the
expectant mother different items. Among other items are mosquito nets, nutritional foods.
Many health facilities here in Malawi use a manual system in helping expectant women in their
antenatal care department. Bangwe Health Centre is not an exception. This manual system has
many challenges. It is therefore on this basis that this project seeks to develop an automated
Antenatal Care Management System (ANCMS) that will be used at Bangwe Health Centre to
automate all processes done at the ANC department.
Bangwe Health Centre is not an exception. Bangwe Health centre is a public medical
institution situated in the south of Blantyre in Traditional Authority Machinjiri. The Health
Centre was opened in 1996. It has about twenty health workers (this includes nurses,
midwives, clinicians, etc) who work in several departments of the Health Centre including
antenatal care. This Health Centre receives an average range of about 30 to 100 expectant
women in its antenatal department (Mrs Mfundula, Bangwe Health Centre’s in charge). This
paperwork information keeping becomes a challenge for a health worker to trace or know
historical records of the patient, among other reasons when the health passport has been lost,
destroyed, changed or forgotten when visiting the facility. Expectant women take advantage
of this and intentionally change, forget or destroy their health passport in order to receive the
items for the second/ third time. Since the current manual process being used is hard, costly,
time wastage and slow for a health worker to track and identify the patient. This patient’s
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malpractice/ behaviour contributes greatly to the shortage and wastage of government
resources being distributed for free to help expectant mothers, and also it gives challenges to
the midwives or doctors to give a proper and required treatment to the woman. Once the
patient chooses to receive the service to another government health facility, He/she cannot be
identified since there is no central repository to keep the details.
1.2.
Problem Statements
The current antenatal system consists of a manual process. This process is about recording the
patient information in a hard copy called a Health passport. The information is about the weight
of the woman in kilograms(kg), the state of the pregnancy, what other diseases the woman
suffers from, and some others. This manual process of data recording by the midwives or nurses
is time consuming and more prone to errors which can lead to doctors and management making
decisions based on wrong information. Besides, these health passports are not very reliable
since they can get lost easily, and they can get damaged easily as well. And most often, these
women intentionally leave their health passports at home so that when visiting the antenatal
care for their second time or so, it should be like it is their first time so that they should receive
the mosquito nets and other things that the antenatal care offers to the expectant woman at the
first visit of her pregnancy at the antenatal care. Hence, due to these kinds of problems, the
proposed system aims to automate the manual process of handling these expectant women so
that the system should be implemented that will be keeping the records of every woman visiting
the antenatal care in a central database so that it becomes easier to trace them and be given a
proper assistant.
1.3.
•
Project-Research Questions
How will the proposed system minimize the problems faced by both health workers and
patients?
•
What is the most effective and efficient way of storing the patient’s records?
•
How many people will benefit from the system?
1.4.
Project Objectives
1.4.1. Main Objective
The main objective of the project was to develop a computerised system for Bangwe Health
Centre’s antenatal department. The system assists in recording, storing, accessing, and
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managing the pregnant women details in a central database so that their records should be kept
safely, privately and securely.
1.4.2. Specific Objectives
The specific objectives are:
•
Examine the current antenatal care system at Bangwe Health Centre and the problems
they face to determine the requirements of the proposed system.
•
To minimise the data losses that are there in antenatal care due to the use of paperwork
which can be easily lost or damaged.
•
To minimise the bad conducts of some women who leave their records intentionally at
home so that when they visit the antenatal care for the next time they should be as new
members and receive some materials that the antenatal care gives to the new member.
•
To design a database, user interface, and management information system for the
antenatal.
•
To develop an antenatal system that will help the health workers to keep the records of
expectant women in a central database.
1.5.
Project Justification
Antenatal care maintains the physical health and peace of mind of the expectant mother,
thereby maximizing the chances for a normal pregnancy and a normal baby. For this reason,
antenatal care needs to be taken very seriously. The use of a manual process to enter, store,
and track patient’s records and their associated information has resulted in crucial problems
in most Malawian Health Centres including Bangwe Health Centre. Through the preliminary
studies conducted at Bangwe Health Centre, it has been noted that almost every day, health
workers face challenges in doing their work due to the problems mentioned already. With
this, some patients do not receive proper treatment and it slows the work of the health
workers.
As such, the project aimed at ensuring that these problems are being prevented from
occurring. This has been done through the implementation of a web-based solution (system)
that automate the manual process (use of a health passport), and be using the automated one.
1.6.
Ethical Consideration
Ethical considerations are important when conducting any research or in the development of
any project. As such this project took into account all applicable ethical considerations to
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maintain objectivity, preserve the dignity and integrity of all individuals and entities involved
in the project. The ethical considerations include:
•
Any confidential information that was encountered during the research was not
disclosed to any individuals without appropriate consent from its proprietors.
•
Users were not, in any way, be influenced to make choices, participate in any
interviews, answer questionnaires, or do some studies without their consent and
against their will.
•
The project was conducted in a professional manner taking into account all ethical
issues in computer software design and development such as accuracy and privacy.
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CHAPTER 2. LITERATURE REVIEW
2.1.
Introduction
Antenatal care is one of the “four pillars” of safe motherhood, as formulated by the Maternal
Health and Safe Motherhood Programme, Division of Family Health, of the World Health
Organization (WHO). The other three are family planning, clean/safe delivery and essential
obstetric care. The package was devised to ensure that women experience safe pregnancy and
childbirth and have healthy infants, in other words, to prevent the dreaded outcomes, such as
maternal death, and perinatal and infant death.
2.2.
Antenatal Care
Antenatal care is the care that women receive during pregnancy that helps to ensure healthy
outcomes for women and newborn babies (WHO/UNICEF 2003). The World Health
Organisation (WHO) has replaced the traditional approach to antenatal care, “a risk approach”,
with an updated approach to antenatal care that emphasises quality over quantity of visits. The
Maternal and Neonatal Health (MNH) programme promotes a minimum of four antenatal care
visits- ideally at 16 weeks, 24-28 weeks and 36 weeks for women with normal pregnancies
(WHO 1994). The new approach is termed focused antenatal care (FANC). The major goal of
antenatal care is to help women maintain normal pregnancies through:
•
Targeted assessment to ensure normal progress of the childbearing cycle and newborn
period, and to facilitate the early detection of complications, chronic conditions, and
other problems that will affect the pregnancy.
•
Individual care to help maintain normal progress, including preventive measures,
supportive care, health messages and counselling (including empowering women and
families for effective self-care), and birth preparedness and the compilation readiness
planning (FANC 2007).
Focused antenatal care (FANC) visits include goal-directed interventions that comprise four
categories:
i.
Health promotion and disease prevention
ii.
Detection and treatment of existing diseases and conditions
iii.
Early detection and management of complications
iv.
Birth preparedness and the compilation readiness
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2.3.
Health promotion and disease prevention
An individual interaction between a provider and a pregnant woman provides a platform to
discuss important issues affecting the woman’s health, her pregnancy, and her plans for
childbirth. Some of the issues discussed during this interaction include the following:
•
Recognition of danger signs, what to do with them and where to get help
•
Good nutrition and its importance to the health of the mother and the unborn baby
•
Good hygiene and infection prevention practices
•
Risk of using tobacco, alcohol, medications, local drugs and traditional remedies
•
Rest and avoidance of heavy physical work
•
Benefits of child spacing to mother and child, including options for family planning
services after the baby’s birth
•
Benefits of breastfeeding, importance of early and exclusive breastfeeding
•
Protection against HIV and other STDs through individualised risk reduction,
availability and benefits of HIV testing and specific issues related to mother to child
transmission and living with AIDS (after a positive test results)
•
It also advocates the following preventive interventions for all pregnant women:
immunisation against tetanus, reduction of iron deficiency anaemia, presumptive
treatment for hookworm, prevention of mother-to-child transmission of HIV,
protection against malaria, protection against vitamin A and/or iodine deficiency
(FANC 2007:2)
2.4.
Detection and treatment of existing diseases and conditions
Antenatal care also involves the detection and treatment of diseases and conditions including
conditions that can severely affect mothers and babies if they are left untreated like HIV,
malaria, syphilis and other sexually transmitted diseases, anaemia, heart disease, diabetes,
malnutrition and tuberculosis (Gloyd, Chai & Mercer 2001).
2.5.
Early detection and management of complications
These include conditions such as severe anaemia, infection, vaginal bleeding, preeclampsia/eclampsia, abnormal foetal growth and abnormal foetal position after 36 weeks
(FANC 2007).
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2.6.
Birth preparedness and compilation readiness
It is important for the health of the mother and the baby that the mother will be well prepared
for the birth of the baby as well as possible complications accompany the birth of a baby. This
includes preparations for the following:
•
A skilled provider to be at the birth
•
The place of birth and how to get there, as well as emergency transportation if needed
•
A person designated to make decisions on the woman’s behalf, in case she is ill and
unable to make decisions herself
•
Support during and after the birth, including someone to accompany the woman and
someone to take care of her family while she is away
•
Blood donors in cases of emergency (FANC 2007)
•
Items for example sterile gloves and cotton wool needed for the birth
•
A way to communicate with a source of help (skilled provider, facility,
transportation).
2.7.
Coverage of antenatal care
The number of pregnant women in developing countries who received antenatal care during
pregnancy was reported to increase significantly by 20% between 1990 – 2001, according to
the joint report issued by UNICEF and WHO (WHO/UNICEF 2003). The greatest progress
was reported in Asia (31%) and the least improvement in Sub-Saharan Africa (4%).
Despite increase coverage of antenatal services worldwide, pregnant adolescent
women, especially the unmarried ones are still categorised among the marginalised
groups who do not get maximum benefits and seize all the opportunities of antenatal
care. Other marginalised groups include migrants, ethnic minorities, the very poor and
those living in isolated rural communities (WHO 2005:42)
2.8.
Effective Antenatal care interventions
A review of the scientific literature regarding antenatal care has identified a number of
antenatal interventions that are effective, as well as those that are not effective but still
used because of tradition. The effective interventions for antenatal care include:
•
Antenatal education for breastfeeding
•
Energy/protein supplementation in women at risk for low birth weight
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•
folic acid supplementation to all women before conception and up to 12 weeks of
gestation to avoid neural tube defects in the foetus
•
iodine supplementation in women with high levels of cretinism
•
calcium supplementation in women at high risk of gestational hypertension
•
smoking and alcohol consumption cessation for reducing low birth weight and
preterm delivery
•
Bran or wheat fibre supplementation for constipation
•
Screening for pre-eclampsia with a comprehensive strategy including an individual risk
assessment at first visit, accurate blood pressure measurement, urine test for proteinuria
and education on recognition of advanced pre-eclampsia symptoms
•
Downs syndrome screening
•
Screening and treatment of asymptomatic bacteriuria during pregnancy
•
Screening for HIV in early pregnancy, a short course of antiretroviral drugs, and
caesarean section for infected mothers at 38 weeks, to reduce vertical transmission
•
Screening and treatment of syphilis
2.9.
Review of the ANC Management systems
This section will present reviews of different examples of ANC management systems that have
been implemented by different health institutions as well as individuals and see how they work.
2.9.1. Mobile Phone-Based Antenatal Care Support System (MPACSS)
MPACSS is a mobile phone system. MPACSS consists of a patient’s mobile phone, hospital
server, an Electronic Medical Record System (EMRS), and a doctor’s remote terminal. The
patient’s mobile phone has the interface that allows patients registration and login details, with
an inbuilt diagnostic application. The hospital server accepts the patient’s data from the mobile
phone and adopts expert system for diagnosis and treatment, while the EMRS manages the
database of patients. The doctor’s remote terminal is a mobile device with same interface as
the patient’s mobile device. The system is built based on an artificial intelligence tool-expert
system that provides an accurate decision-making process. This system has a Graphical User
Interface (GUI) which allows the patient to access the application using a mobile phone to get
the lists of symptoms that the patients click or select at a time. However, this system does not
automate antenatally and postnatal routines, clinical test, and report generation. Also, the
system is a native mobile application that is expensive to implement by other healthcare clinics
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like Bangwe Health Centre and since some women do not have smartphones, this system might
not be ideal in Health Centres like Bangwe.
Below is an image showing the architecture of MPACSS.
Figure 1: Architecture of MPACSS
2.9.2. Electronic Personal Maternity Records (EPMR)
EPMR was designed and implemented as both a web-based service and a multi-platform
application for smartphones and tablets. This system has three novel features. These include:
i.
Web-based maternity records, which contains concise explanations of various antenatal
screening and diagnostic tests
ii.
Self-care journals, which allow expectant women to keep track of their gestational
weight gains, blood pressure, foetal movements, and contractions
iii.
Health education, which automatically presents detailed information on antenatal care
and other pregnancy-related knowledge according to the women’s gestational age.
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A survey was conducted among pregnant women to evaluate the usability and acceptance of
the proposed system. In order to prove that the antenatal care was effective, clinical outcomes
should be provided and the results were focused on a usability evaluation.
Below is an image showing the architecture of EPMR:
Figure 2: Architecture of EPMR
2.9.3. Women’s Digital Care Record (WDCR).
The WDCR aims to support maternity services and offers women digital versions of their care
record by replacing traditional paper records and support maternity services. The WDCR
supports women with the opportunity to contribute towards their record, providing a greater
understanding which then impacts on care.
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For example, a woman may choose to:
•
Capture and share images, videos or record appointments
•
Capture personalised care planning and support relevant to the stage of her pregnancy
•
Share information with the midwife before they meet, through a questionnaire, to
enable the midwife to have a more personalised conversation with her
•
Have access to her pregnancy record alongside the team caring for her.
Below is an image showing the architecture of WDCR.
Figure 3: Architecture of WDCR
2.9.4. Review of the proposed system
Based on the review of the already existing systems, the proposed system will include the
following features:
•
The patient inspection will involve checking if the patient is a new member or not
•
Patient management will involve adding, editing, and deleting patient information
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•
Report production. The system will be producing weekly, monthly, and yearly reports
that will be used in many sectors when needed. The reports will be about how many
women visit the antenatal care weekly, monthly, and yearly. And how the system is
benefiting both the patients and healthcare workers in general so that it will be easy to
give feedback to the relevant authorities like the DHO.
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CHAPTER 3. METHODOLOGY
3.1.
Overview
This chapter provides a detailed discussion on the research process and methods that
were followed during the study and the justification on why the methodology was chosen for
the development of the project. A methodology is defined as a formalized approach to
implementing the SDLC (Denis, Wixon, & Roth, 2012). The system development approach,
the stages of the approach adopted and how each stage was implemented in the project will be
explained in details in the sections of this chapter.
3.2.
System Development Approach
Rapid application development approach was used to develop the system. ‘Rapid application
development is a collection of methodologies that emerged in response to the weaknesses of
waterfall development and its variations. RAD incorporates special techniques and computer
tools to speed up the analysis, design, and implementation phases in order to get some portion
of the system developed quickly and into the hands of the users for evaluation and feedback’
(DENNIS, et al., 2012). To be more specific, system prototyping technique was used. System
prototyping required the analysis, design and implementation phases to be done concurrently
in order to get a simple version of the system into the hands of the users.
The technique was appropriate for the system due to its nature as it allowed users such as the
Hospital In charge and all nurses, clinicians, and midwives at Bangwe Health Centre to test the
system and provide feedback, in which I was able to make necessary changes and improve
usability of the system. Another benefit of using RAD was that it was easy and cost effective
to interact with the users and give them prototypes for testing because of the short distance
between Bangwe Health Centre and MUBAS. MUBAS was the primary location where the
system was developed. The following is the diagrammatic representation of the RAD approach.
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Figure 4: System Prototype Methodology
The prototypes evolved into a final system. Most of the feedback provided by users was to do
with the user interface, how information should be presented and what words to use to represent
the modules. The main issue with prototyping is that some phases such as analysis are rushed
in order to deliver a prototype to users, this resulted in users making several changes to the
system especially the system interface. Not all the changes given by the user were
implemented, they first went through a change management process. The change management
process involved:
•
Receiving the change or request. This happened after showing the users the system
prototype.
•
Assessing the change. Time was one of the limiting factors to the development of the
project, therefore each change was analysed to see how much time it would take. This
was done so that it wouldn’t largely affect the Gantt chart.
•
If the change was not largely affecting the Gantt chart, it was implemented and the
relevant sections of the document were changed in order to reflect the change.
3.3.
Data Collection Methods
The methods which were used for data collection include documents analysis, interviews,
observation, and prototype evaluation.
3.3.1. Documents Analysis
Several documents were analysed to get thorough understanding and detailed information
about the ANC operations and processes.
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3.3.2. Interviews
Interviews were done with the Hospital in charge (Mrs Mfundula), one nurse, and three
randomly selected expectant mothers. The purpose of interviewing the employees was to
understand how the current system work and get the overview of the processes in the ANC.
Face to face and telephone interviews were used, but telephone interviews were much used due
to the COVID restrictions. Both open and closed ended questions were asked and the feedback
was recorded in a diary and sometimes the interview was recorded with a smartphone, and the
recording was done with the consent of the interviewee.
3.3.3. Observation
The current system was observed to better understand how they work. The observations were
carried out at the Health Centre. They were mainly done to see how the ANC department
operates.
3.3.4. Prototype Evaluation
Since the ANC management system utilised system prototyping of the RAD approach,
prototype evaluation was also used to gather data. The other features which the users needed
to be included or removed within the system were identified since there were some early
releases of the system prototype which the users were able to test and give feedback.
3.4.
Data Analysis
After collecting the data, it was analysed, which involved organizing it. Qualitative data
analysis method was used because most of the collected data was qualitative. A deductive
approach to qualitative data analysis was used because it was likely that the responses to the
questions asked were already available. It was also used due to its nature of taking less time as
compared to the inductive approach. This was preferred because there was limited time
available to develop the system. The research questions in chapter 1 were used as a guide in
grouping and analysing the data.
3.5.
Process Analysis
Process analysis was done in order to understand and present activities and processes
performed by the ANC department. This was done using a process modelling technique called
data flow diagramming (DFD). The DFD shows the flow of data through the processes, and
the input and output of each process. During process analysis, the DFD helped illustrate how
the processes and activities are going to be performed by the Hospital In charge, and the health
care provider. The DFD is shown in next chapter (Chapter 4: Analysis).
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CHAPTER 4. REQUIREMENTS ANALYSIS
This section summarizes the analysis that was used in this project. It outlines the tools and
techniques that were used for analysis and the outcome of the analysis. It includes the functional
and non-functional requirements, use cases, process models and data models. According to
Denis, Wixon, & Roth (2012) a requirement is simply a statement of what the system
must do or what characteristics it needs to have. Furthermore, Denis, Wixon, & Roth (2012)
writes that requirements describe what the business needs, what the user needs, what the
software should do (functional requirements), characteristics the system should have (nonfunctional requirements) and how the system should be built.
4.1.
Functional requirements
Functional requirements for a system describe what the system should do. The requirements
depend on the type of software being developed and the expected user of the software
(Sommerville, 2011). In the ANCMS, the system consists of two users namely the hospital in
charge, and a nurse or midwife. The functional requirements of the system include:
•
The ANCMS must enable a nurse/midwife to add or to register patients into the system.
•
The system must enable a nurse/midwife to view the patient’s details.
•
The system must enable a nurse/midwife to give a patient advice on healthy eating and
physical exercises based on the health of the patient.
•
The system must enable a nurse/midwife to give relevant drugs to the patient based on
the nature of the pregnancy and other diseases that the woman suffers so that she has a
healthy pregnancy.
•
The system must enable a nurse/midwife as well as the hospital in charge to edit the
patient’s details.
•
The system must enable the administrator to edit, and view patients details as well as
change the password of the entire system when there is a need to do so.
•
The system must enable a nurse/midwife as well as the hospital in charge to delete the
patient into the system (in cases where the patient passes away).
•
The system must be able to list all patients visiting the ANC in the following week or
month so that the nurse/midwife should have the full knowledge on which patients they
are supposed to help next and be able to know the all the required resources those
patients will need.
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•
The system must enable the hospital in charge to produce reports and print them in an
appropriate format to be used when needed.
•
The system must be able to perform search. The system must allow a user to search for
a for patient information based on a given criteria i.e., name.
•
The system must allow only authorized users to access the system.
4.2.
Non-functional requirements
According to (Sommerville, 2011), non-functional requirements are requirements that are not
directly concerned with the specific services delivered by the system to its users. These
requirements are concerned with operation, performance and security of the system
4.2.1. Operational Requirements
•
The system shall be hosted on both UNIX/Linux and Windows server
•
The system shall be accessed through any web browser
•
The system shall enable the user to print reports produced by the system
4.2.2. Performance Requirements
•
The ANCMS should be available for use 24 hours per day, 7 days per week, 365 days
per year
•
The system should process all the patient data in the quickest time possible and
produce reliable output
•
The system should allow multiple users to access the systems database simultaneously
4.2.3. Security Requirements
•
Only the administrator can be able to change the system’s password
•
The user shall be required to use username and password to gain access into the system
•
Integrity of data would be enforced for example; passwords need to be encrypted in
order to safeguard against unauthorized access.
•
Validation needs to be enforced, forms should have proper data validation methods to
ensure that appropriate data types such as dates, e-mail addresses and decimals are
captured by the database.
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4.2.4. Usability Requirement
•
The system shall notify the user of the ANCMS when certain actions have been
performed for instance the deletion of a record
•
The BANCMS should allow its users to perform critical functions without any
assistance
•
The BANCMS should be easy to learn by both new users and users with experience
from previous relatable systems
4.3.
Use Cases
The objective of the use case model is to identify and define all of the elementary business
processes that the system must support. Use case diagrams provides an overview of all the use
cases for a system (Satzinger, Jackson, & Burd, 2010). Furthermore, information is described
with a use case description. Implied in all use cases is a person who uses the system called the
actor.
4.3.1. BANCMS Use Case Diagram
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Figure 5: BANCMS Use Case Diagram
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4.3.2. Use Case Descriptions
Use Case 1
Use Case ID
1
Use Case Title
Login
Description
For the Authentication of the user, the input credentials of the users
have to match with the ones in the database for the user to access the
system.
Primary actor(s)
Nurse/midwife, Hospital in charge, administrator.
Priority
High
Precondition
User must be registered and assigned a role in the system by the
Administrator
Trigger
User clicks the login button
•
Primary Scenario
The user enters username and password on the
login form
•
The system authenticates the credentials entered by the user against the credentials found
on the database
•
Response
If credentials match, the user to the homepage.
Confirmation message that user has successfully logged in
Table 1: Use case 1
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Use Case 2
Use Case ID
2
Use Case Title
Add patient
Description
This use case is for adding of a new patient into the system. Patients are required to provide
their personal profile/details to be filled into the system.
Primary actor(s)
Nurse/ midwife, Hospital in charge
Priority
High
Precondition
User must be logged in as Nurse/Midwife or Hospital in charge
Trigger
User clicks the Add Patient button
Primary Scenario
Response
•
A patient must provide her details to the hospital attendant.
•
The hospital attendant must record the patient’s details into the system.
Confirmation that the patient has been added successfully.
Table 2: Use case 2
Use case 3
Use Case ID
3
Use Case Title
Checks Pregnancy period
Description
This use case if for checking the duration of the pregnancy. The hospital attendant tests the
woman to check on the duration of the pregnancy.
Primary actor(s)
Nurse/Midwife
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Priority
High
Precondition
User must be logged in as a Nurse/Midwife. A Nurse/Midwife must test the woman’s pregnancy
to see its period and then tell the patient so that she should know how old is her pregnancy.
Trigger
User clicks the Manage Patients Button.
•
Primary Scenario
The hospital attendant must do his/her test to know the pregnancy duration and be able
to tell the patient.
Response
The test is recorded into the system so that the counting starts and all the required things should
be given to the patient.
Table 3: Use case 3
Use Case 4
Use Case ID
4
Use Case Title
Give patient drugs
Description
This use case if for giving drugs to the patient. The hospital attendant examines the patient
pregnancy and provide the necessary drugs to the patient based on the nature and period of the
pregnancy.
Primary actor(s)
Nurse/Midwife
Priority
High
Precondition
User must be logged in as a Nurse/Midwife. A Nurse/Midwife must first examine the kind of
drugs that the patient takes or must take based on the previous records.
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Trigger
User clicks the Manage Patients Button.
Primary Scenario
•
The hospital attendant must do his/her test to provide the necessary drugs to the patient.
•
The hospital attendant also checks into the system to see the kind of drugs that the
patient was previously given so that she/he provides the required drugs to the patient
based on the dates of the woman’s pregnancy.
•
Response
The hospital attendant gives the patient necessary drugs based on his/her test.
The given drugs are recorded into the system.
Table 4: Use case 4
Use Case 5
Use Case ID
5
Use Case Title
Give patient advice
Description
This use case is for advising the patient. The hospital attendant checks the health of the patient
and gives her advice on what exercises and other remedies that the woman must do.
Primary actor(s)
Nurse/ Midwife
Priority
Medium
Precondition
User must be logged in as a Nurse/ Midwife. A Nurse/ midwife checks the profile of the patient
to see if there are some improvements on the woman’s health based on the current examination,
and she/he provides the required advice to the patient based on his/her findings.
Trigger
User clicks the Manage Patients Button.
•
Primary Scenario
The hospital attendant gives the necessary advice to the patient based on his/her
findings.
Response
The user records the kind of advices given.
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Table 5:Use case 5
Use Case 6
Use Case ID
6
Use Case Title
View patient details
Description
This use case is for viewing patient details. A nurse/midwife can view the patient’s details in the
system to see how best he/she can help the patient.
Primary actor(s)
Nurse/ midwife
Priority
High
Precondition
User must be logged in as a Nurse/ Midwife. Then she/he checks the details of the patient to see
what kind of drugs is the woman taking, age of the woman, what kind of resources the woman
was already given, what resources the woman needs, and many more.
Trigger
User clicks on view button on a particular patient that she/he wants to view her details.
•
Primary Scenario
The hospital attendant provides the necessary and required service to the patient based
on the viewed details.
Response
All the materials and drugs given to the patient are recorded into the system.
Table 6: Use case 6
Use Case 7
Use Case ID
7
Use Case Title
Edit patient details
Description
This use case is for editing the patient details. The hospital attendant must edit the wrongly
inputted details for the patient to have the correct data.
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Primary actor(s)
Nurse/ midwife
Priority
High
Precondition
User must be logged in as a Nurse/ Midwife. If there are some information which were wrongly
inputted into the system, she/he must edit to have the correct information.
Trigger
To have the required correct and information into the system.
•
Primary Scenario
The hospital attendant double checks the patient’s details so that the correct information
is recorded into the system.
The correct and edited patient’s details is recorded into the system.
Response
Table 7: Use case 7
Use Case 8
Use Case ID
8
Use Case Title
Delete patient
Description
This use case is for deleting the patient including all of its details. In cases where the patient
dies or has given birth, she must be deleted into the system.
Primary actor(s)
Hospital in charge
Priority
High
Precondition
User must be logged in as a hospital in charge. The hospital in charge then checks all the
patients who have given birth and deletes them into the system. Also, patients who have passed
away before given birth must also be deleted into the system.
Trigger
User clicks on the Delete Patient button.
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•
Primary Scenario
The hospital in charge deletes all patients who are doing nothing in the system. These
are patients who have given birth and all those who have passed away.
Response
All the deleted patients must not appear in the system after being deleted.
Table 8: Use case 8
Use Case 9
Use Case ID
9
Use Case Title
Patient health eating advice
Description
This use case is there to advice the patients on health eating so that she should have the health
pregnancy and health foetus as well.
Primary actor(s)
Nurse/ midwife
Priority
Medium
Precondition
User must be logged in as a Nurse/ Midwife. Then she/he checks the details of the patient into
the system more especially if there are improvements in the woman’s pregnancy. Then she/he
advices the patient on health eating if there is a need to do so.
The user clicks on the manage patient’s button.
Trigger
•
Primary Scenario
The hospital attendant provides the necessary and required advice to the patient on the
health eating habits and the nutritious foods that the patient must be eating to have a
healthy pregnancy.
Response
The advice being given to the patient are recorded into the system.
Table 9: Use case 9
Use Case 10
Use Case ID
10
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Use Case Title
Patient physical exercises advice
Description
This use case is there to advice the patient do be doing physical exercises regularly so that she
should have a healthy pregnancy and a healthy baby.
Primary actor(s)
Nurse/ midwife
Priority
Medium
Precondition
User must be logged in as a Nurse/ Midwife. Then she/he checks the details of the patient into
the system more especially if there are improvements in the woman’s pregnancy. Then she/he
advices the patient to be doing physical exercises and what exercises she must be doing if there
is a need to do so.
The user clicks on the Manage Patient’s button.
Trigger
•
Primary Scenario
The hospital attendant provides the necessary and required advice to the patient on the
physical exercises that the patient must be doing so that she has a healthy pregnancy.
Response
The advice being given to the patient are recorded into the system.
Table 10: Use case 10
Use Case 11
Use Case ID
11
Use Case Title
Report production
Description
This use case is used to produce reports
Primary actor(s)
Hospital in charge
Priority
Medium
Precondition
User must be logged in as a hospital in charge. Then she will produce a report about the ANC
and being able to put that report in a specific format for example in a pdf format or excel.
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The user clicks on the Manage Patient’s button.
Trigger
•
Primary Scenario
The hospital in charge checks all the records of the patients in the system and then she
produces a report concerning the records to be used later when needed.
Response
The report being produced is printed in a specified format, i.e., pdf or excel.
Table 11: Use case 11
Use Case 12
Use Case ID
12
Use Case Title
Logout
Description
This use case if for logging out of the system.
Primary actor(s)
Nurse/Midwife, hospital in charge, administrator.
Priority
High
Precondition
The user must be logged into the system.
Trigger
The user clicks the logout button.
•
Primary Scenario
Response
User clicks on the logout link
The user is redirected to the login page
Table 12: Use case 12
4.4.
Process Modelling and Data Flow Diagrams
Process models are graphical ways of representing how a business system should operate, it
mainly illustrates the processes or activities that are performed and how data moves among
them (Denis, Wixon, & Roth, 2012). This section presents the process models that were
drawn during the analysis phase of the project and these models represents the processes in
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the BANCMS. Data Flow Diagram (DFD) were used as a tool to model the processes of the
project. Data Flow Diagrams illustrates how data flows from one process to another process.
DFDs have four main components which are a process, data flows, external entity and data
store. The following subsections presents BANCMS’s context diagram and its level 0 DFD
will be presented in the system design stage.
4.4.1. Context Diagram
The context diagram depicts the entire system in the context with its environment. In
addition, it shows the overall business process as just one process and shows the dataflows to
and from the external entities (Denis, Wixon, & Roth, 2012). This subsection will illustrate
the context diagram of the BANCMS, the BANCMS has two external entities.
Figure 6: BANCMS Context Diagram
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CHAPTER 5. SYSTEM DESIGN
5.1.
Overview
The system design stage of the project describes how the new system will operate (Denis,
Wixon, & Roth, 2012). The system design uses the requirements gathered during the analysis
section to create a blueprint for the future system. Therefore, this chapter elaborates on the
designs of the system that were developed from the requirements collected from the users.
BANCMS (Bangwe Antenatal Care Management System) the process design which is in the
form of a Level 0 DFD, ERD, interface design layouts, interface structure design, database
schema and system architecture diagrams have been illustrated in the subsequent sections of
this chapter.
5.2.
Level 0 Data Flow Diagram
Level 0 Dataflow Diagram shows the major processes, data stores and the external entities,
(Denis, Wixon, & Roth, 2012). It also shows the data that flows between one process to
another and data that flows to the data stores. Figure below therefore shows the system’s
Level 0 DFD, showing all the processes in the BANCM system and how they are interrelated
to each other.
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Figure 7: BANCMS Data Flow Diagram
5.3.
Data Modelling and Entity Relationship Diagram (ERD)
A data model is a formal way of representing the data that are used and created by a business
system. (Denis, Wixon, & Roth, 2012). It illustrates people, places, or things about which
information is captured and how they are related to each other. This section presents the
logical Entity Relationship Diagram, which generally presents the logical organization of the
data in the BANCM database. Therefore, figure 11 below shows the Logical ERD for the
BANCM System that has been developed.
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Figure 8: BANCMS Entity Relationship Diagram
5.4.
System Architecture Design
The BANCMS was built based on the client server architecture, client-server-based attempt
to balance the processing between the client and server. In this type of architecture, the client
is responsible for the presentation logic the screen which the user interacts with, whereas the
server is responsible for the data access logic and data storage. (Denis, Wixon, & Roth,
2012). From this understanding the server will store the application logic and database of the
BANCMS. Hence, the client will be able to access the BANCMS through the use of the
Local Area Network (LAN). The diagram to illustrate this is shown in figure below.
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Figure 9: System Architecture design
5.4.1. Page Layout
This subsection of the document is written to illustrate the page layout design that was used
in the development of BANCM system. The page layout design is used to display the
arrangement of components such as menus, navigation bars and content areas in the system
pages. A wireframe diagram is used to show the layout structure of the system. Furthermore,
Wireframe diagrams are used to convey the basic content and behaviour of the screen (Denis,
Wixon, & Roth, 2012). The diagrams below show the wireframe diagrams for BANCM
system.
Figure 10: Interface design layout template for the login page
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Figure 11: Interface design layout template for the admin home page
Figure 12: Interface design layout template for the hospital incharge home page
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Figure 13: Interface design layout template for a Nurse/ Midwife home page
5.4.2. Messages
Messages are defined as the way in which the system responds to a user and informs him or
her of the status of the interaction. Messages that were designed for the system are presented
in such a way that they are clear, concise and complete. The BANCM system has been
designed to use three types of messages namely Acknowledgement messages, Confirmation
Messages and Error messages.
5.4.3. Input Design
Input design means designing the screen used to enter the information as well as any forms
on which the users write or types (Denis, Wixon, & Roth, 2012).
The system will be installed on the desktop computer in the Bangwe ANC department. The
system will accept text and numerical data into the system. The input devices to be used to
enter the text and numerical data will be a keyboard and a mouse. A physical or virtual
keyboard will be used to enter textual data into the system for example when using forms,
while the mouse will be used to navigate through the system by clicking or selecting different
user interface controls. Methods of inputting data to the system include entering data using
forms and importing excel sheets (batch input method) for entering multiple records at a
single time. To enhance data accuracy which is entered into the system, input design
techniques have been used.
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The first technique is that all data entered into the system must be validated in order to ensure
accuracy. Different types of validation checks are performed by BANCM system which
include completeness check, these checks if all fields have been filled before the system
processes the data. Format check, the system also checks if the data inputted is of correct type
and Database checks is implemented in the login module where username and password
inputted are checked if they match with the ones stored in the database.
The other technique is that keyboard stroking has been minimized through the use of dropdown boxes. For example, when the user wants to enter the date of birth of a patient, he or
she is not required to manually type the DOB of the patient, as such the user is presented with
a select box which enables the user to select from the list of dates therefore preventing errors.
5.4.4. Output design
Output is defined as the reports that the system produces whether on the screen or on paper
(Denis, Wixon, & Roth, 2012). The system produces different types of output from the
information retrieved from the database.
The following are the outputs produced:
o Tables – Information in the database is displayed in a tabular form.
o PDF document – The system produces PDF documents that can be downloaded
and viewed.
5.5.
Database Design
The database design is concerned with designing how data is to be stored and handled by the
functions that run the system. The BANCM system was designed to use relational databases.
In this section we will illustrate the physical Entity Relationship Diagram and the database
schema of the system.
5.5.1. Physical Entity Relationship Diagram (ERD)
This subsection will illustrate how the data depicted in logical ERD will physically be stored
in the database. The ERD will illustrate the entities and their relationship in the database. The
figure below shows a diagram of the BANCM system physical Entity Relationship Diagram
that has been formed by reverse engineering with BANCM database.
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Figure 14: Physical Entity Relationship Diagram for the BANCM System
5.5.2. Database Schema
This section presents the structure of the BANCM database in form of tables. The entities in
the table are as shown in Figure above.
Patient
Attribute
Type
Length
Default value
Description
id
Varchar
11
NOT NULL
Primary key for the
Patient table.
firstname
Varchar
20
NOT NULL
First name of the patient.
surname
Varchar
20
NOT NULL
Surname of the patient.
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dob
Date
NOT NULL
Date of birth information
of the patient.
children
Integer
2
NOT NULL
number
phone_no
Varchar
Total number of children
that a woman has.
10
NULL
Phone number of a
patient.
Table 13: Patient schema
Patient_visits
Attribute
Type
Length
Default value
Description
patient_id
Varchar
11
NOT NULL
Primary key for the
Patient_visits table.
Visiting_date
Date
NOT NULL
The date a patient visited
the ANC to be added in
the system.
Table 14: Patient_visits schema
materials_given
Attribute
Type
Length
Default value
Description
patient_id
Integer
11
NOT NULL
Primary key for the
number
name
Varchar
materials_given table.
40
NOT NULL
Name of the materials
given.
date_given
Date
NOT NULL
Date of which the
materials were given.
Table 15:Materials_given schema
patient_next_visit
Attribute
Type
Length
Default value
Description
patient_id
Varchar
11
NOT NULL
Primary key for the
patient_next_visit table.
next_visit
Date
Table 16: Patient_next_visit schema
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NOT NULL
Date of the next visit.
problems
Attribute
Type
Length
Default value
Description
patient_id
Integer
11
NOT NULL
Primary key for the
problems table.
problem_name
Varchar
100
NOT NULL
Name of the problem the
woman has.
date_diagonised
Date
NOT NULL
Date that the problem was
diagnosed.
Table 17: Patient problems schema
treatment
Attribute
Type
Length
Default value
Description
patient_id
Integer
11
NOT NULL
Primary key for the
treatment table.
treatment_given
Varchar
70
NOT NULL
The type of treatment
given to the patient.
date_given
Date
NOT NULL
Date that the treatment
was given to the patient.
Table 18: Patient treatment schema
users
Attribute
Type
Length
Default value
Description
id
Integer
11
NOT NULL
Primary key for the users
table.
username
Varchar
20
NOT NULL
Username of the one
(user)logging in into the
system.
password
Varchar
20
NOT NULL
Password of the user.
role
Varchar
20
NOT NULL
The role of a particular
user into the system.
Table 19: User’s schema
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CHAPTER 6. SYSTEM IMPLEMENTATION AND TESTING
6.1.
Overview
This chapters describes the tools and technologies that were used to develop the system, the
testing procedures done and a short manual on how the system can be installed and used.
After finalizing the analysis and design of the Bangwe Antenatal Care Management System,
it was now time to build a system prototype. The implementation follows an outline of
system construction testing and development of user documentation. The key system features
that have been developed to accommodate the functional requirements that were determined.
The test plan, the actual tests and the test results that were conducted on the system’s key
features have also been presented in this chapter. Lastly, this chapter elaborates on the
deployment plan and all the requirements needed for the successful deployment of the
BANCMS.
6.2.
Key System features of the BANCM system
The key features that have been developed for the system to accommodate the key functional
requirements have been discussed in the following subsections:
6.2.1. Adding a new patient
One of the key features of the system is to add a new patient into the system. After the
developer coded the patient’s module, the system is able to allow the nurse/midwife to add a
new patient into the system. The patient is required to provide all her details to be inputted
into the system and these details are kept into the system’s database.
6.2.2. Viewing patient details
Viewing patient details is also another key feature of the system. A user is able to view all the
details of a patient being recorded into the system if there is a need to do so. This module is
there to save the time of asking a patient about her details each and every time a patient visits
the ANC. It also helps a user to know or see the proper and recommended help to give a
patient.
6.2.3. Editing patient details
This is also one of the key features included in the system. This module has been successfully
implemented in the system so that a user has a chance of editing the patient’s information if
there is a need to do so. If there were some errors made when entering the patient’s profile, a
user can just edit the erroneous part instead of deleting the whole record just to correct a
small mistake. This module saves time and also minimizes errors.
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6.2.4. Deleting a patient
This feature is also included into the system. This feature is there to delete all the patients
who are not doing anything into the system. These are patients who have given birth and also
those patients who have passed away before they give birth. This feature is useful to reduce
the inconsistencies of the system and also it is there to save the system’s space by avoiding
keeping the information that has no any use into the system as this kind of information can
just eat up the system’s space for nothing and in one way or the other compromise the
system’s security.
6.2.5. Searching a patient
Searching has been included into the system as an easy way of finding a patient record in
case there are a lot of patients in the system’s database. A user can search a patient with
either a first name or a surname instead of going through all the records just to find a single
patient. This feature also saves time.
6.2.6. Accessing the system
Accessing the system is also one of the key features of the system. This functional
requirement requires the users of the system to only access the system when the user has been
authenticated by the system. The user is required to enter their username and the password. If
the credentials match with those in the database, then the user is automatically given access to
the system. If the credentials are incorrect, the error message is displayed.
6.3.
System construction
By definition, System Construction consists of all of the activities required to build and
validate the new system to the point at which it can be turned over for System Acceptance.
Development efforts in this phase is based on the technical solution created during System
Design, which, in turn, was based on the functional and operational requirements captured
during System Requirements Analysis. The following section therefore describes the
programming languages, frameworks, tools and techniques that were used in developing the
system.
6.3.1. PHP
Hypertext Preprocessor (PHP) was used to develop the system because it is suitable for web
development and the developer was familiar with the programming language. However, a
pure PHP was used rather than using a framework.
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6.3.2. MYSQL
MySQL is an Oracle-backed open source relational database management system (RDBMS)
based on Structured Query Language (SQL). MySQL runs on virtually all platforms,
including Linux, UNIX and Windows. Although it can be used in a wide range of
applications, MySQL is most often associated with web applications and online publishing.
With the development of this project, MySQL was used to store and access data in the
database. It was used because it is free and easily scalable.
6.3.3. JAVASCRIPT AND JQUERY
JavaScript and jQuery (a JavaScript) were used to implement the client side of the
application. The two libraries were used in order to make the web application more dynamic.
JavaScript helped define the logic at browser level and it makes the system more efficient and
faster for some functionalities in comparison to using the framework. For example, the search
functionality on the system uses JavaScript as it retrieves the information much faster.
6.3.4. HTML and CSS
Hyper Text Markup Language (HTML) and Cascading Style Sheets (CSS) were used to
create the user interface. HTML was used to describe the document content and provide the
structure of the document while CSS was used to describe the presentation and the styles of
the document (colors, fonts etc.). The project was developed using HTML5 and CSS3 which
are the latest versions. The new versions were used because they ensure the system is
responsive and accessible.
6.3.5. SUBLIME TEXT
Sublime Text is a commercial source code editor. It natively supports many programming
languages and markup languages. Users can expand its functionality with plugins, typically
community-built and maintained under free-software licenses.
Sublime text editor was the editor used to work on the HTML, CSS, JavaScript, and PHP
code.
6.3.6. MYSQL WORKBENCH
MySQL Workbench is a unified visual tool for database architects, developers, and DBAs.
MySQL Workbench provides data modelling, SQL development, and comprehensive
administration tools for server configuration, user administration, backup, and much more.
MySQL Workbench is available on Windows, Linux and Mac OS X.
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MySQL workbench is a visual tool that was used to visually design, model, create and
manage databases. The design is shown, under database design. MySQL workbench was also
used to test some database queries before including them in the system and for inserting
dummy data (used for testing the system).
6.3.7. PHPMYADMIN
phpMyAdmin is a free software tool written in PHP, intended to handle the administration of
MySQL over the Web. phpMyAdmin supports a wide range of operations on MySQL and
MariaDB. PhpMyAdmin was also used to enter dummy data into the system for testing.
6.3.8. EDRAW MAX
Edraw Max is a 2D business technical diagramming software which help create flowcharts,
organizational charts, mind map, network diagrams, floor plans, workflow diagrams, business
charts, and engineering diagrams. Edraw Max was used to draw some of the diagrams in
chapter 4 and 5 such as DFD’S, ERD and navigational structures. The reason for using Edraw
Max instead of Visio was that some of the drawings such as ERD and DFD’s were easier to
create with Edraw than Visio and it provided more options.
6.4.
Coding
The project was coded using pure PHP, HTML, CSS and MySQL. The source code was not
included in the document but in the CD because the files contain a lot of lines of code. The
code is presented together with the document.
6.5.
System Testing
Testing was carried out to ensure that the system is successfully performing and is compliant
with the requirements defined in chapter 4. This section describes the techniques and methods
used in testing the system, the test cases and results of the testing. The system was tested
using two testing methods which included black box testing and white box testing.
6.5.1. Blackbox testing
Black box testing involves testing a system with no prior knowledge of its internal workings.
A tester provides an input, and observes the output generated by the system under test. This
makes it possible to identify how the system responds to expected and unexpected user
actions, its response time, usability issues and reliability issues. The testing was done by
fellow students and some workers from Bangwe Health Centre. The testing was done to
ensure the system produces the correct output from the input given.
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6.5.2. Whitebox testing
White Box Testing is software testing technique in which internal structure, design and
coding of software are tested to verify flow of input-output and to improve design, usability
and security. In white box testing, code is visible to testers. The testing was done by myself
(the developer). Some of tasks during this testing involved determining all the valid and
invalid inputs (legal and illegal) and verifying against the expected outcome while also
studying the implementation code.
6.6.
Compatibility Testing
Two types of compatibility tests were done in order to determine the operating systems and
web browsers the system was compatible on.
6.6.1. Operating System Compatibility
The system was tested on several operating systems for compatibility. Below is a table
summarizing operating system compatibility testing.
Operating system
Compatibility status
Windows Xp
Not tested
Windows 7
Compatible
Windows 8 & 8.1
Compatible
Windows 10
Compatible
MAC OS
Not tested
Linux (Debian 9)
Not tested
Table 20: OS compatibility Testing
6.6.2. Web Browser Compatibility
The system was tested on several web browsers to test for compatibility. The table below
shows the results.
Browser
Compatibility status
Mozilla Firefox
Compatible
Google Chrome
Compatible
Opera Mini
Not tested
Internet Explorer
Compatible
Microsoft Edge
Compatible
Table 21: Web browser compatibility Testing
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6.7.
Testing levels
The levels of tests that were conducted on the BANCMS include the Unit, Integration and
System tests. These tests were used to make sure that all the units are working as intended in
the requirements and that the whole system is working without errors. In order to effectively
test the system, a proper test plan has been developed. A test plan defines a series of tests that
will be conducted. The test plan template that was used to test the system is shown below.
The actual tests and result recorded from the test plan have been elaborated in section 6.8.
BANCMS Test Plan
Test ID:
Script:
Date Designed:
Date Conducted:
Tester:
Result:
Objective:
Test Case:
Requirement Addressed:
Expected Result:
Actual Result:
Table 22: Test Plan Template
The test plan shown in the table above was used to make sure that the system’s functional
requirements that were proposed during the system analysis phase have been implemented. A
number of different test types were conducted on the system during implementation and these
tests are well elaborated below:
6.7.1. Unit Testing
This is a type of testing where individual units or components of the software are tested. The
purpose is to validate that each unit of the software code performs as expected. Unit testing is
done during the development (coding phase) of an application. During unit testing, the
modules of the system were individually tested to make sure they work correctly. The
modules were tested independently to ensure that they were functioning as defined in chapter
4. The testing was done by the developer.
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6.7.2. Integration Testing
This is the second level of the software testing process that comes after unit testing. In this
testing, units or individual components of the software were tested in a group. The focus of
the integration testing level was to expose defects at the time of integration between
integrated components or units. The testing was done by the developer. Below is a
diagrammatic representation showing the integration testing.
Figure 15: Integration testing diagram
6.7.3. System Testing
This means the testing of a complete and fully integrated software product. After the
completion of the system, the system was tested as whole to ensure it meets all the
requirements defined in chapter 4. The testing was done by the developer.
6.8.
Tests and Tests results
This subsection highlights on the actual tests and their results that were conducted according
to the test plan presented in table 22. The tests depicted here are those of the key system
features as already discussed above. The following are the tests conducted on the key system
features;
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Test 1
BANCMS Test Plan
Test ID: 1
Script: index.php
Date Designed: 15 – 06 - 2021
Date Conducted: 05 – 07 - 2021
Tester: Blessius Nyirenda
Result: Passed
Objective: Log in into the system with the
Test Case: Log into the system
wrong credentials to verify that only authorized
users can access the system.
Requirement Addressed: The system must allow only authorized users to access the system
Expected Result: The system does not allow the user to login
Actual Result: Invalid Credentials
Table 23: Test 1
Test 2
BANCMS Test Plan
Test ID:
Script: patients.php
Date Designed: 24 – 07 - 2021
Date Conducted: 30 – 07 - 2021
Tester: Blessius Nyirenda
Result: Passed
Objective: Record new patient into the system.
Test Case: Enter the patient’s personal
information/profile.
Requirement Addressed: The system must enable the user to record a new patient into the system.
Expected Result: The system should produce a form which the user should use to enter the details of
the patient so that the patient together with her details are recorded into the system’s database.
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Actual Result: The system is able to record patients and store the recorded patients in a table form
showing the Patient ID, Firstname, Surname, Date of Birth, Number of children the patient has, and the
location where the patient comes from.
Table 24: Test 2
Test 3
BANCMS Test Plan
Test ID: 3
Script: dischargePatient.php
Date Designed: 03 – 08 - 2021
Date Conducted: 06 – 08 - 2021
Tester: Blessius Nyirenda
Result: Passed
Objective: To discharge a patient.
Test Case: Click the Discharge button on the
Patient Record.
Requirement Addressed: The system must enable the user to discharge a patient into the system.
Expected Result: The system should produce a form which the user should use to discharge a patient.
The form should contain all the personal information of the patient to be discharged, if the patient has
delivered successfully or not, number of children the woman has delivered if successfully delivered, and
the delivery date.
Actual Result: The system is able to discharge a patient and all the discharged patients are stored in a
table form showing the Patient ID, Firstname, Surname, and the date discharged.
Table 25: Test 3
Test 4
BANCMS Test Plan
Test ID: 4
Script: editPatientDetails.php
Date Designed: 15 – 08 - 2021
Date Conducted: 20 – 08 - 2021
Tester: Blessius Nyirenda
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Result: Passed
Objective: To edit the patient details
Test Case: Click the edit icon on the Edit menu.
Requirement Addressed: The system must enable the user to edit the patient details.
Expected Result: The system should produce a page containing different forms that enables the user to
edit the details of a patient she or he wants.
Actual Result: The system is able to produce the edit page where the user can edit the patient details.
Table 26: Test 4
Test 5
BANCMS Test Plan
Test ID: 5
Script: patients.php
Date Designed: 12 – 09 - 2021
Date Conducted: 15 – 09 - 2021
Tester: Blessius Nyirenda
Result: Passed
Objective: To search for a patient.
Test Case: Click the search box on the New
Patient window.
Requirement Addressed: The system must enable the user to search for a patient.
Expected Result: After a user has inputted what she or he wants to find in the system, the system
should be able to produce that particular record.
Actual Result: The system is able to produce an entry that the user has searched.
Table 27: Test 5
6.9.
Deployment Plan and The Requirements needed for Successful Deployment
The following two subsections presents on what can be done in order to successfully deploy
the ANCM system for Bangwe Health Centre.
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6.9.1. Deployment Plan
The deployment plan outlines the scope, approach and execution planned for the deployment
of the project delivered. The deployment plan is intended to provide clients, stakeholders and
support personnel with a smooth transition to the new product or software being deployed
(Washington, n.d.). For the actual transition the developer proposes that the parallel
conversion approach. Parallel conversion is an approach whereby the old and new system are
used simultaneously (Denis, Wixon, & Roth,2012). Hence, BANCMS has to put in place a
deployment plan that uses parallel conversation approach because the approach reduces risks
by providing the organization with a fallback position if a major problem is experienced with
the new system. The deployment plan according to Washington n.d includes five major
activities for the successful conversion from the manual system to the automated system.
The deployment plan includes the setting up of the sever and network infrastructure for the
system to be installed in, this also includes setting up relevant hardware infrastructures such
as computers. The other activity involves installing the ANCMS on the server which was
configured in the first activity, so that the system can start running. Another activity involves
mitigation of all the antenatal data and associated data to the new system. The other activity
involves training the system users on how to use the system. The last activity involves
monitoring the transitioning activity to ensure all activities from both the new and old system
are being monitored, and after some period of time the output from both systems will be
carefully compared to ensure that the new system is performing correctly. As such, after
some period of parallel operation and intense comparison between the system, the use of the
old way of dealing with antenatal work will be discontinued (Washington, n.d.).
The table template below shows the deployment plan for the new system.
#
Deployment Activity
1
Building and Configuring
the Server, Network and
Hardware Infrastructure
2
Installing and configuring
software (BANCM
system)
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Activity By
Date
Remarks
3
Migrating data from the
old system into the new
system
4
Training users of the
system
5
Monitor transition using
parallelism
Table 28: Deployment plan template
6.9.2. The Requirements Needed for Successful Deployment of the System.
This subsection presents specific hardware and software components that should be available
if the PMCM system is to function as required.
6.9.2.1.
Software Requirements
Table below shows the recommended software specifications for the BANCM System:
Software
Minimal Requirements
Optimal Requirements
Operating System (OS)
Windows 7
Windows 10
Chrome (version 83.0),
Chrome (current version),
Firefox (version 74.0),
Firefox (current version),
Internet Explorer 8
Internet Explorer 11
Web Browser
Table 29: Recommended software specifications for BANCMS
In addition to the above client software requirements, PDF readers for example Adobe reader
should also be installed on client computers in order to be able to view PDF documents that
are produced by the system. Lastly, Microsoft office has also to be installed in the client
computer in order to read the report.
6.9.2.2.
Hardware Requirements
Table below shows the recommended hardware specifications for the BANCM System:
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Component
Minimum Requirement
Recommended Requirement
HDD
At least 10 GB of free space
At least 30 GB of free space
RAM
512 MB
4 GB
CPU
x86-capable dual core
X64-capable quad core
processor with speed of 1.4
processor with speed of 2.4
GHz or more.
GHz or more.
Table 30: Recommended hardware specifications for BANCMS
6.10. System Specifications
The following are the recommended specifications to run system:
1. Apache 2.4.33 or higher
2. MySQL 5.7.22 or higher
3. PHP 7.2.4 or higher
4. Web browser (any)
5. Windows 7 or higher
6. WAMP 64
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CHAPTER 7. CONCLUSION
This section describes each objective of the system and how it is achieved, recommendations
for the project and a concluding statement about the project.
7.1. Discussion of Objectives
The main objective of the project was to develop a computerised system for Bangwe Health
Centre’s antenatal department. The system assists in recording, storing, accessing, and
managing the pregnant women details in a central database so that their records should be kept
safely, privately and securely. The objectives below describe all the activities that were done
to achieve the main objective.
7.1.1. Objective One
The first objective was to examine the current antenatal care system at Bangwe Health Centre
and the problems they face during the process of treating pregnant mothers. This
objective was achieved by accomplishing several activities which included interviews and the
analyzing of existing documents.
Interviews were conducted with the hospital in charge, nurses, midwives, clinicians, and some
patients. These individuals explained thoroughly on how the antenatal department handles its
work on a day-to-day basis. These interviews helped me as the developer of the system
understand better of the current system and see some areas of improvement.
Document analysis also proved a vital element in understanding the current system. Several
documents were analyzed which helped me understand the current system better as well.
7.1.2. Objective Two
The second objective was to determine system requirements (functional and non-functional
requirements) to address the problems identified. The requirements were collected by
analyzing documents and interviewing the hospital in charge several time. The requirements
were then analyzed using tools such data flow diagram and use case diagrams, which helped
create and identify the concepts of the to-be system.
7.1.3. Objective Three
The third objective was to design the database, system architecture and user interface that meet
the requirements of the ANC. Various diagrams representing the designs were produced which
include Entity relationship diagram, physical model of the database, navigational structure and
layout designs.
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7.1.4. Objective Four
Several system prototypes were developed through the course of developing this system. This
was another objective of the system. This provided a platform where the user was able to
provide feedback after prototype evaluation. This facilitated that design should have addressed
what the user wants since the users had the chance to provide feedback. In the end, a working
prototype was developed based on user requirements and needs.
7.1.5. Objective Five
The final objective was to Build and test the new BANCM system using the designs
developed. The system was implemented using a PHP and MYSQL for the backend and
HTML5, CSS3, java Script for the front end and a test plan was created to make sure that the
system that has been developed has no errors and that it meets all the functional requirements
defined in section 4.1.
7.2. Experiences
The experience of working on the development of this system was very exciting to the
developer and his knowledge in this field has been greatly improved. The practical experience
of system analysis and design methodologies provided valuable programming and project
management skills. I was further privileged to interact with the Bangwe hospital in charge as
well as some other employees there, including some pregnant women that I found at the ANC.
7.3. Challenges and Limitations
The project was not simple and straight forward. It required application of many skills gathered
during the four years of study. One of the major challenges I faced during the project was on
the technical part of designing and developing the system. This was mainly in terms of program
coding and query designing, especially on some complex queries that required me to search on
how best to come up with an algorithm for a particular query.
Another big challenge was the restrictions that were there to physically meet different people
(the hospital in-charge, nurses, patients) to collect data from them with the Covid pandemic.
This was really a big challenge as some interviews which were designed to be done face-toface were done using a phone (phone calls and WhatsApp). And interviewing the patients was
really a big challenge as it was not easy to find their contact numbers and also some of them
do not have the mobile phones. With this challenge, I ended up spending a lot of money to buy
airtime credit to do the interview which was an easy task.
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But overall, it has been an interesting and great experience to actually develop and design a
working prototype, which can actually be implemented by Bangwe Health Centre. This has
provided me with so much confidence that I am now well equipped with knowledge that I can
use in the industry to help solve business problems using Information Technology skills. In
addition, throughout the development of the system, I have developed a better understanding
on system development and project management which will help me mange future
development projects in the real world.
7.4. Recommendations
The system developed meets the requirements that were collected and it is recommended that
the Bangwe Antenatal Care uses it in their day-to-day operations to improve efficiency.
The system works as intended but there is still room for improvements regardless of meeting
all the requirements. The following are the recommendations:
✓ The system does not back up its current state. The future version should include a
backup functionality for the users to be able to restore it back to its previous state in
case of system failure.
✓ Inclusion of a help menu to help users further with terminology and usage of the
system. Since this will be an online system which will need some of the basics of
computer literate.
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https://study.com/academy/lesson/writing-research-questions-examples.html
Your antenatal care. (2021, March 20). Retrieved from Antenatal care website:
https://www.nhs.uk/pregnancy/your-pregnancy-care/your-antenatal-care/
Definition of Systems Design. (2021, August 15). Retrieved from Definition of Systems
Design website: https://economictimes.indiatimes.com/definition/systems-design
Hamilton, T. (2021, October 2). How To Write The Test Cases. Retrieved from How To
Write The Test Cases website: https://www.guru99.com/test-case.html
System Testing. (2021, September 10). Retrieved from System Testing website:
https://www.guru99.com/system-testing.html
Women's Digital Care record. (2021, August 6). Retrieved from Women's Digital Care
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Retrieved from A Step-by-Step Guide to Creating a Deployment Plan website:
https://www.fool.com/the-blueprint/deployment-plan/
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APPENDICES
Appendix A: Interview Questions
Below is a guideline and list of questions that was used to interview system users.
Interview Number 1
Name of Interview
:
Interview Date
:
Start Time
:
End Time
:
Objective of the Interview: Have a basic overview, background, and understanding of
Bangwe Health Centre including its antenatal care and all the operations at the antenatal in
general.
1. General Questions
1.1. When was Bangwe Health Centre opened?
………………………………………………………………………………………………
1.2. How many workers (Nurses/ Midwives) does the health centre has?
……………………………………………………………………………………………..
1.3. What is the average number of pregnant women the health centre receives per day?
…………………………………………………………………………………………
1.4. What is the average number of pregnant women get treated at the health centre’s
antenatal care per day?
…………………………………………………………………………………………..
1.5. How many patients does one health worker supposed to help per day? (Nurse – Patient
ratio).
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…………………………………………………………………………………………….
2. Other Questions
2.1. Which steps/ process does the pregnant woman has to follow to get treated from the
beginning to the end (briefly explain)?
…………………………………………………………………………………………
………………………………………………………………………………………….
………………………………………………………………………………………….
………………………………………………………………………………………….
2.2. What happens when a patient forgets or loses her health passport and wants to access
treatment?
…………………………………………………………………………………………..
…………………………………………………………………………………………..
…………………………………………………………………………………………..
2.3. What is your responsibility as health workers when a patient arrives and wants to be
treated?
…………………………………………………………………………………………..
…………………………………………………………………………………………..
…………………………………………………………………………………………..
2.4. Additional information (any information you would like to add concerning the
antenatal care and its operations)?
…………………………………………………………………………………………..
…………………………………………………………………………………………..
…………………………………………………………………………………………..
…………………………………………………………………………………………..
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Interview Number 2
Name of Interview
:
Interview Date
:
Location
:
Start Time
:
End Time
:
Objective of the Interview: To examine the current system?
1. How do the current system (use of health passports) work?
……………………………………………………………………………………………...
………………………………………………………………………………………………
………………………………………………………………………………………………
2. What information is kept in a health passport?
………………………………………………………………………………………………
………………………………………………………………………………………………
3. Where do you store the patient’s information apart from the health passport?
………………………………………………………………………………………………
………………………………………………………………………………………………
4. What information do the current systems produce?
………………………………………………………………………………………………
………………………………………………………………………………………………
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5. What are the challenges faced in using the current system?
………………………………………………………………………………………………
………………………………………………………………………………………………
………………………………………………………………………………………………
6. Additional information (any information you would like to add concerning the current
system)?
Interview Number 3
Name of Interview
:
Interview Date
:
Location
:
Start Time
:
End Time
:
Objective of the Interview: To know the users of the system
1. Who is expected to use the system and what are their titles?
…………………………………………………………………………………………………..
…………………………………………………………………………………………………..
…………………………………………………………………………………………………..
2. What are the roles of each title?
…………………………………………………………………………………………………
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…………………………………………………………………………………………………
………………………………………………………………………………………………….
3. Who is more likely to use the system?
………………………………………………………………………………………………….
4. Additional information (if any)?
………………………………………………………………………………………………….
………………………………………………………………………………………………….
………………………………………………………………………………………………….
Interview Number 4
Name of Interview
:
Interview Date
:
Location
:
Start Time
:
End Time
:
Objective of the Interview: To gather information on how the to be system should be like
1. What would you want the system to do?
………………………………………………………………………………………………….
…………………………………………………………………………………………………..
………………………………………………………………………………………………….
2. Any suggestions or preferences on how the user interfaces should be designed?
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…………………………………………………………………………………………………..
…………………………………………………………………………………………………..
…………………………………………………………………………………………………..
3. What security features should the proposed system include?
…………………………………………………………………………………………………
…………………………………………………………………………………………………
………………………………………………………………………………………………….
4. What reports should the proposed system produce?
…………………………………………………………………………………………………
………………………………………………………………………………………………….
………………………………………………………………………………………………….
5. How do you want the reports to be produced?
…………………………………………………………………………………………………
…………………………………………………………………………………………………
………………………………………………………………………………………………….
6. Additional information (if any)?
…………………………………………………………………………………………………..
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…………………………………………………………………………………………………..
…………………………………………………………………………………………………..
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Appendix B: The Installation Process and Copying Files in Windows Operating System
The BANCM system was entirely developed using a Windows 10 operating system. A local
host server was used during the development of the system WAMP server for Windows
operating system. This section therefore aims to illustrate the installation of WAMP server on
a Windows machine so as to test or use the BANCM system.
1. Installing WAMP Server
For the system to work, a web server must be installed on the server machine. For this system,
WAMP server version 3.2.3 32bit version was used. To install WAMP, the following steps
were used;
i.
Right click on WAMP (wampserver3.2.3_x86.exe) and select “run as administrator” to
begin installation.
ii.
Select Language and click OK (English language was selected).
iii.
Accept License Agreement and click NEXT.
iv.
Read the information about the agreement and click NEXT.
v.
Select Destination Location that you want your WAMP to be located and click NEXT.
vi.
Select Start Menu Folder and click NEXT.
vii.
If ready to Install, click INSTALL (The installation process begins. Wait until the
installation ends).
viii.
Click NEXT to finish the installation.
ix.
Launch the WampServer
x.
To see if its working, open a browser and enter “127.0.0.1” or “localhost”. WampServer
home page will be shown if the installation was successful.
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Figure 16: WampServer Installation
2. Installing Mozilla Firefox
The Web browser which was used to test the system was Mozilla Firefox Version 92.0.1(64bit). A higher version of Firefox can also be used or other browsers such as Google Chrome
(20 or higher) and Microsoft Edge, Opera web browser can be used. The following are the
steps to be followed to install Firefox.
i.
Double click on the Firefox set up file.
ii.
A welcome page pops up, click next to continue.
iii.
Choose the standard type on the set-up type and continue to click next.
iv.
Continue clicking next on the following pages that pop up until the finish page. Make
sure to click the launch icon checkbox to before clicking finish.
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Figure 17: Mozilla Firefox Installation
3. Copying source code files
Below are the steps to copy the source code files to appropriate folder.
i.
Copy the ‘chipa’ folder in the disc. Copy by right clicking and selecting copy.
ii.
Go to local disk drive (C:) and open the ‘wamp’ folder.
iii.
The last step is to open the ‘www’ folder and paste the ‘chipa’ folder.
4. Importing the database
The database needs to be imported for the system to be able to function. The file name is
‘bangwe’. Below are the steps followed in the process of process of importing the database:
i.
Double click WAMP server icon if it is not on
ii.
Open Mozilla Firefox and type ‘http://localhost/phpmyadmin/’ in the address bar.
iii.
A PHPMYADMIN login page is displayed. Enter root as the username and leave
the password field blank and click ‘go’.
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Figure 18: phpMyAdmin login
iv.
Click “import” on the phpMyadmin page
Figure 19: phpMyAdmin homepage
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v.
Click ‘browse’ and select the ‘bangwe.sql’ file in the disc. After selecting the file,
scroll down to the end of the page and click ‘go’ to begin the importing process.
Figure 20: phpMyAdmin import page
vi.
After the database is imported, the system can now run.
5. Running the system
After everything is set, the system can now be run after making sure that:
i.
You run WAMP and “W” icon is green.
ii.
Database is successfully imported.
iii.
The “chipa” folder is in the required specified location.
Then open the browser and type ‘http://localhost/chipa/’ in the address bar.
Figure 20 shows the login page for the system. All users are required to access the BANCM
system by using this page.
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Figure 21: BANCMS login page
Login Credentials
After successfully running the system and the login page is displayed, a user is now able to
login into the system to access system features. The table below displays a list of credentials
that can be used to login into the system.
NB: These credentials are what I have included so far, but an administrator can add more
users and give them credentials. Those credentials are what will be used by those users to
access the system.
Username
Password
Role
admin
admin
Administrator
bago
123
Hospital in-charge
ssymon
12345
Nurse/ Midwife
Appendix C: System Manual
This section is a guideline on how to use the system. The system uses a single login page
for all types of users and the page redirects them to their homepage or dashboard according to
their credentials and roles assigned to them. The login credential inputted by the user are
cross checked with the credentials which are found in the database. Table above shows the
users of the system and their login credentials.
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A) Nurse/ Midwife User Manual
Once a user with credentials of a Nurse/ Midwife logs into the system, she or he is redirected
to the Nurses/ Midwives dashboard. The page is divided into two parts, the left pane has main
navigation links which provides quick access to pages the user wants to go while the centre
pane is where the user works. The figure below shows the Nurses or Midwives home page or
dashboard.
Figure 22: Nurse/ Midwife dashboard
1. Adding a New Patient
To add a new patient into the system, click on the New Patients button on the left pane or the
Patients tab on the centre as shown at the screenshot above. Then a collapsible menu will
appear then click on New Patient and follow the steps by entering all the details required then
click Save if you really want the patient to be added into the system. If you do not want to
add the patient into the system, click Close. The screenshot below shows the steps described.
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Figure 23: Creating a New Patient
As shown on the screenshot above, the New Patient button is the one used when a user wants
to add a new patient into the system. After clicking that, the user is redirected to a form which
she or he uses to add a patient into the system by entering all the patient’s details necessary to
be added. Below is a screenshot that the user uses to add a patient into the system.
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Figure 24: A form used to add a new patient into the system
After the user has successfully added a patient into the system, the patient now becomes part
of the system.
2. Editing a Patient
This feature has been successfully added into the system to give room for a user to edit or
make corrections on the patient’s details in case there were some errors made when inputting
them and also to record some important information of the patient including the patient’s bio
data, home address, problems a patient has, etc. A user can access this feature by clicking the
New Patients button, then a page like the figure 22 comes. Here under the Edit section, go to
the patient you would like to edit her details by clicking on the Pencil-like feature under the
Edit section. After doing that, you will be given a page that contains more tabs including Bio
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Info, Home Address, Problems, Materials given, and Treatment given. Click on the tab that
you want to work with. The screenshot below shows the edit part.
Figure 25: Edit feature.
As shown on the above screenshot, the user wants to edit the Bio info of the patient. But
when a user for example wants to record the problems of the patient, she or he has to click the
Record problems tab and will be directed to another page that she or he can use to record the
problems as shown below.
Figure 26: Record problems page
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As shown on the above screenshot if a patient has more problems, the user has to click the
Record More button so that she or he can record all the problems that the woman has.
3. Discharging a patient
This is also another feature included into the system. A nurse or midwife can discharge a
patient on different reasons. To access this feature, click on the New Patients button. Then on
a page like the figure 22 above, click the Discharge tab under the Discharge feature on the
patient you would like to discharge. Below is a page that come after clicking the Discharge
tab.
Figure 27: Discharge page
As the screenshot is showing, the right part shows the details of the patient you would like to
discharge while the left part is a form for the user to use in order to discharge the patient.
After filling all the necessary details on the form, the user has to click the Submit button, here
that patient will appear on the Discharged Patients section. The screenshot below shows a
page of the discharged patients.
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Figure 28: Discharged patients
4. Searching a patient
The search feature is one of the key functionalities included into the system. This has been
added in order to ease the job of a nurse or midwife by going through all the entries just to
find one patient since there may be a lot of patients in the system. So, with a search feature, a
user can find a patient she or he wants in a short period of time. To search for a patient, a user
can use either the patient’s firstname, surname, or her phone number. Below is a screenshot
showing how the search feature works in this system.
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Figure 29: Searching using surname
As shown on the screenshot above, I tried to search Eunice Malunga using her surname on
the search text field. The system has given one entry since there is only one person with
Malunga surname which is Eunice Malunga. Here the system has filtered all other entries that
do not match with the search and showing only one entry that matches.
As already stated, searching can also be done using the patient’s phone number as shown
below:
Figure 30: Search using phone number
The search also shows one entry since there is only one person with such a phone number
which is Elida Tongole.
B) Hospital Incharge Manual
Once a user with credentials of a Midwife logs into the system, she or he is redirected to the
Incharge dashboard. Just the same with the Nurse page, the Incharge page is divided into two
parts, the left pane has main navigation links which provides quick access to pages the user
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wants to go while the centre pane is where the user works. The figure below shows the
Incharge home page or dashboard.
Figure 31: The hospital Incharge dashboard
As seen on the screenshot above, the hospital incharge has the same roles with those of a
Nurse/ Midwife, the only difference is on Reports. The Hospital Incharge is the one
responsible to produce different reports of the system that is why she or he is assigned the
Reports module. All other modules are just the same with those of a Nurse/ Midwife.
Figure 32: BANCMS general report
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As the screenshot shows, when a user clicks the Print Report button, he or she is given the
print option where he or she can print the report in a PDF format with the options specified.
C) The Administrator Manual
Once a user with credentials of an administrator logs into the system, she or he is redirected
to the administrator dashboard. The administrator has all the functionalities of a Nurse/
Midwife and those of a Hospital Incharge as well. He or she can do everything that a nurse or
the incharge can do since he is the one controlling the system. Hence the Administrator
dashboard has all the modules as of the nurse/ midwife and those of the incharge, but he or
she has a Settings which a nurse/ midwife and the incharge do not have. With the Settings
tab, an administrator can add users, edit a user, and delete a user as well. Below is a
screenshot to show the Administrator dashboard.
Administrator dashboard
When a user clicks the settings tab, he or she is given the options to add a user, edit the user,
and delete the user as well. The screenshot below shows how the settings tab works in this
system.
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Figure 33: Admin settings tab
After an administrator has added a new user into the system, that user is given all the
necessary credentials and role. The user will be using those credentials when she or he wants
to access the system.
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