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Full Project – Android-based maternal and child care information management system

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CHAPTER ONE

INTRODUCTION

Background of the Study

The Mother and Child care unit also known as Antenatal unit in the outpatient Department of any hospital letters for medical advices and treatments to expecting mothers before delivery Mother and Child care is all about mothers and their fetuses’ care, to see that the baby is developing without malformation and giving mothers advice on what to eat, type of exercise needed scanning and pathology rest. Each year, about 290,000 women lose their lives due to pregnancy and delivery related causes, and about 6.9 million children die before they turn five. 99% of these maternal and childhood deaths occur in developing countries.

The three major infectious diseases, namely HIV/AIDS, tuberculosis and malaria, also kill 3.35 million people each year. In many countries, especially in sub-Saharan Africa, these diseases hinder economic and social development. Among the eight Millennium Development Goals (MDGs) set in 2000, three goals put the health sector front and center; Goal 4 (reduce child mortality), Goal 5 (improve maternal health), and Goal 6 (combat HIV/AIDS, malaria and other diseases). To achieve these goals, lower income countries have been making an effort to improve the situation, with their governments increasing expenditure on health and reducing out-of-pocket health expenditures.

In the same period, the international community has significantly increased its development assistance for health; the United States and other countries increased their bilateral funding, while new multilateral funding mechanisms such as the Global Fund to Fight AIDS, Tuberculosis and Malaria emerged. Private foundations including the Bill & Melinda Gates Foundation have also played an important role.

With these efforts, the health of people in the developing world has improved. For example, 12.6 million children under age five died in the 1990s; twenty years later, that number has decreased to 6.9 million in 2011.

However, especially in lower income countries, improvements in maternal and child health, and in infectious disease control, have been too slow. In some countries, the MDGs are unlikely to be achieved by 2023. In others, country-wide health indicators have improved, but the level of disparity within the country remains unacceptable. This inequality in health especially affects the poor, people in dire need of health services, and people living in remote areas. These technologies could act as a catalyst for providing basic antenatal services to the pregnant women who live in the cities or underprivileged/underserved rural areas, where antenatal care facilities are either non-existent or of extremely poor quality. The pregnant women in these areas have to travel great distances over a highly inefficient transportation system to reach the nearest maternity or health care center. Subsequently, a large number of pregnant women die, mostly in emergency scenarios due to lack of immediate medical attention. This phenomenon is particularly evident by a very high Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) in Nigeria (Ogunjimi et al., 2012; World Health Organization, 2010). Researchers are now interested in providing critical antenatal care services to the pregnant women at their door steps in real-time by utilizing the services of modern wireless networks and the Internet.

Consequently, it can be observed that in many developed countries such systems are planned to provide health care to the aging people at their homes (Demongeot et al., 2008). The prevailing situation clearly indicates the failure of the current health infrastructure, especially for maternities in Nigeria. There is the need for revamping the ICT infrastructure as an enabler (United Nations Development Programmed, 2010). It is necessary to provide universal access to clinical services in a cost effective manner at the primary care level (Adam et al., 2005; Abubakar et al., 2013A). Consequently, healthcare programs and systems are needed which must ensure effective health measures and inexpensive community based interventions in public and private sectors (Sule & Onayade, 2006). The current medical statistics clearly indicate that the situation is catastrophic and have reached epidemic stage. The gravity of the problem is further aggravated due to scarcity of medical practitioners. In Nigeria, according to World Health Organization, (2010), the ratio of medical practitioners is 30 Doctors for 100,000 population, 100 Nurses for 100,000 population, 68 Midwives for every 100,000 population, 11 Pharmacist for 100,000 people and 2 Dentists for every 100,000 population. There are great disparities in health status and access to health care among different population groups in Nigeria. For example, the under-five mortality rate in rural areas is estimated at 243 per 1000 live births, compared to 153 per 1000 in urban areas (DHS, 2009]). While 59 percent of women in urban areas deliver with a doctor, nurse, or midwife, only 26 percent of women in rural areas does so (DHS, 2009). Sub-Saharan Africa had the highest MMR at 500 maternal deaths per 100, 000 live births (World Health Organization, and United Nations Development Programme, 2010; Ogunjimi et al, 2012).

At the country level, the two countries account for one third of global maternal deaths: India at 9% (56 000) of all global maternal deaths, followed by Nigeria at 14% (40 000). This situation is totally in contrast with the scenario in the developed countries. For example, in comparison to MMR of 800 deaths per 100,000 live births in Nigeria, MMR in UK is only 0.6 on the same scale (World Health Organization, 2010). Nigeria is the most populous black nation on the surface of the earth and had maternal mortality rate of 280 to 1150 per 100,000 live births (Onwumere, 2010). Factors associated with these problems include, poor socioeconomic development, weak health care system and lower socio-cultural barriers to care utilization (Ibeh, 2008). Nigeria is second on maternal mortality rate in the world with about 144 girls and women dying every day from complication of pregnancy and childbirth. 1 in every 18 women die giving birth compared to 1 in 4800 in the US (Pitterson, 2010; Daily Independence, 2010). According to the survey conducted in February 2010, the record stands at between 165 per 100,000 live births in the South West and 1549 per 100,000 live births in the North East (Onuwumere, 2010; Ogunjimi et al., 2012).

The obstetric record as initiated at the antenatal booking clinic essentially identifies the degree of risk engendered in that pregnancy so that consequent obstetric and pediatric management is tailored appropriately. Whether carried by the patient or based in the hospital with a summary carried by the patient (shared-care card), this record should be exhaustive, the emphasis being on quality, not quantity, of information recorded. To obviate human error in history-taking, patient management or record transcription, we believe on-line computerization of patient records with spin-off paperwork to be the only patient management system to fulfil the above criteria. User-friendly software can be designed with highly branching programmes which provide clinical action suggestions in high-risk cases. Various ‘error traps’ enhance the accuracy of information recorded. Such systems can be operated by medical and midwifery staff with minimal keyboard skills and are well accepted by patients and staff. Inexpensive and versatile microcomputer networks are excellent for such systems. The operational effects are discussed. Audit means different things to different people and one’s view on the subject depends on which definition is selected. Obstetricians are quick to take credit for instituting audit in the form of local and national data collection exercises, such as statistics on perinatal mortality, birth weight, etc. While these exercises certainly constitute observational studies, they cannot be used to make conclusions about the quality of care. There is no sound inference that can be made from a review of information contained in amalgamated databases of hospital statistics. Audit, as properly defined, hinges on inference: the inference that the quality of care was or was not of a high standard. Descriptive statistics, therefore, can be used to generate hypotheses but should not be used as a form of audit, at least not in obstetrics. Auditing the quality of care involves a study of process. It therefore depends on the assumption that we know which practices maximize beneficial outcomes. This exercise is therefore only relevant when we have good evidence linking the process of care with these outcomes. In some cases the accepted standard against which the process of care can be compared is very obvious. In other cases, however, the accepted standard should itself be audited to ensure that it is based on sound evidence.

Statement of the problems

Maternal mortality is the deaths of women during pregnancy, delivery or within 42 days after delivery. Infant mortality is the deaths of infants of less than one year of age. Maternal mortality and infant mortality remain among the major healthcare challenges in the developing countries. For example, during the year 2015, the average number of maternal deaths per 100,000 live births in the developing countries was 239, versus 12 in the developed countries. Moreover, during the year 2016, estimated 4.2 million infants died during their first year of life, accounting for 75% of deaths of children aged less than 5 years. Further, it is estimated that 99% of these maternal and infant deaths occur in developing (low-and middle-income) countries.

Aims and Objectives of the Study

The aim of this study id to develop an android based maternal and child care management system and this can be achieved with the following objectives;

To develop an android based maternal and child care management system to improve maternal and child health services in order to decrease maternal and childhood morbidity and maternity
The system should be able to enhance the availability of information of antenatal patients to doctors.

The system should be able to enhance quick retrieval of information and adequate storage of the antenatal patients.

The system should be able to provide the necessary vital information to the antenatal patients and as well provide the information to the doctors.
- Significance of the Study

There are setbacks in information dissemination and flow in God’s care Specialist Hospital Antenatal unit thus the research felt the need to embark on this study in other to identify and provide solutions to those setback as the objectives of the work include.

The work will create on awareness of the ideal contents of Antenatal care which include: Preconception counseling, Assessment of risk factors, Assessment of fetal well-being etc.
The work will be able to provide information on educating especially first time pregnant mothers about normal discomforts of pregnancy, Emotional aspects (including post-natal depression so that these mothers are being reassured and fears driver away.

The study will be able to incorporate a software that can keep track of information about Antenatal patients and their History (medical examinations)

The study will be able to clear the doubts of the relevance of Antenatal care.
And lastly the work is centered on educating mothers, providing information to health care agents and the antenatal unit for proper information flow.

1.5 Scope of the Study

This work only covers the provision of information related to the Antenatal unit of the outpatient department of God’s care specialist hospital or another other hospital that will integrate this sytem in their hospital.

Limitation of the Study

In the process of carrying out this research work, some factors tried to hinder the free flow of work. These factors include

Time: Time factors in the sense that the semester was short and as a result combining this work with studies was tedious.
Finance: Finance were rather on the lean side and as a result it affected the carrying out of the research in that monetary commitment was needed for going to the case study, photocopying document, browsing etc.

Definition of Terms

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