Implementation of Web-Based Health Management System for National Health Insurance Scheme

ABSTRACT Web-based health management system for National Health Insurance Scheme is considered in this project work as an online information storage and retrieval internet portal where the stakeholders registered and participating in the National Health Insurance Scheme of the federal ministry of Health will be able to access relevant information regarding NHIS. The Internet portal will also be useful to prospective or intending participants who want to key into the programme. The stakeholders in the NHIS programme include Health Management Organizations, Health care Providers, health care professionals, tertiary institutions, federal employers and employees, agencies and parastatals, enrollees, Banks, Insurance companies and armed forces. The Health Management Organizations (HMOs), are classified into national , zonal, and state, while the health care providers consist of primary, secondary, tertiary and specialists. The health care professionals on the other hand are categorized into general medical practitioners, ophthalmologists, radiologists, dental surgeons, pharmacists, nurses/midwives. The other stake holders in the scheme include the non governmental organizations and paramilitary men .The Scheme is aimed at providing access to health care delivery services to the federal government workers, including the armed forces, students of tertiary institutions as well as other enrollees in the programme at subsidized rates on contributory basis. The main features of the system design include Home page where other menu items are displayed and accessed. The menu items include About Us, Operating Guidelines, NHIS Programmes, Requirements, NHIS Registration, Staff, profile, View, identity card and Frequently Asked Questions (FAQ).Each of the above listed menu items has other sub programme modules which allows the visitors to the site as well as the staff of the NHIS or the Administrators to use or work with the system for entry and display of users data respectively. The system can as well be queried for various options of activities .The implementation of the above design was carried out using Adobe Dream Weaver CS5, HTML, PHP Script programming language as the front end. Various database objects like Tables, Forms and Queries were created using MySQL at the backend. Different Graphical User interface windows were designed to enable all the stake holders or visitors to the website to interact with the system. Internet Explorer or Mozilla fire fox or any other browser can be used to visit the website. Comparison of features of different software Engineering process models for instance Iterative and Incremental process models were done. Various UML use-case diagrams were used to showcase the functionality of the new system. Implementation of health Insurance schemes in both developing and developed nations were also discussed. The portal address for this work is http://www.nhisng.org

TABLE OF CONTENTS

Title Page i

Approval Page ii

Dedication iii

Acknowledgement iv

Abstract v

List of Tables vi

List of Figures vii

Table of Contents x-xvi

CHAPTER ONE

INTRODUCTION

1.1 Background of the study 1

1.2 Project definition: 2

1.3 Statement of problems 2

1.4 Aims and objectives of the project 4

1.5 Justification for the project: 4

1.6 Scope of the project 5

1.7 Project organization 5

CHAPTER TWO

LITERATURE REVIEW

2.1 The Evolution of National Health Insurance Scheme in Nigeria 6

2.1.1 Introduction 6

2.1.2 Historical Perspectives 7

2.1.3 Objectives of National Health Insurance Scheme 8

2.1.4 Benefits of the Scheme 9

2.1.5 Types of Health Insurance Scheme 10

2.1.6 How the Scheme Operates in Nigeria 10

2.1.7 Strategies/Implementation Action Points in Nigeria 12

2.1.8 Launching of National Health Insurance Scheme by President Olusegun Obasanjo in June 2005 13

2.2 The need for National Health Insurance Scheme 14

2.3 Health Insurance Scheme In Nigeria 16

2.4 The implementation of the National Health Insurance Scheme 18

2.5 The Posers 19

2.6 Achievements: 20

2.7 Past and present challenges of National Health Insurance Scheme in Nigeria 20

2.8 National Health Insurance Scheme; Panacea to Quality Health System in Nigeria 22

2.9 National Health Insurance Scheme: Popular name or a model for realistic change in Healthcare delivery in Nigeria 24

2.10 National Health Insurance Scheme (NNHIS) and Employees’ access to Healthcare Services in Nigeria 27

2.11 Obstruction And Resuscitation of NHIS in Nigeria 29

2.12 Stake Holders of National Health Insurance Scheme: 30

2. 13 Health Care in some developed Countries 32

2.13.1 Spending 34

2.13.2 International Comparisons of Health care Systems 34

2.13.3 Government involvement 36

2.13.4 History 36

2.13.5 Health Insurance 37

2.14 Funding of Healthcare 37

2.16 Accreditation of Mutual Health Associations (MHA) 39

2.16.1 Introduction 39

2.16.2 Membership 39

2.16.3 Contribution/Premium 39

2.17 National Health Insurance Scheme Programs 39

2.18 General requirements for Health Care Providers (HCPs) 40

2.19 Guidelines for the Armed Forces, Police and allied services 40

2.20 Federal Ministry of Health (Nigeria) 41

CHAPTER THREE

RESEARCH METHODOLOGY, SYSTEM ANALYSIS AND DESIGN

3.1 Research Methodology 42

3.2 Methods of data collection 42

3.2.1 Primary source 42

3.2.2 Secondary source 42

3.3 Analysis of the System 42

3.4 Limitations of the existing system 43

3.4.1 Proposed solutions to the above limitations 43

3.5 Choice of Software Development Process 43

3.5.1. Software Process Models 44

3. 5.2 Comparison of five Process Models 44

3.5.2.1 The Waterfall Model 45

3.5.2.1.1 Pure Waterfall 47

3.5.2.1.2 Modified Waterfall 48

3.5.2.2 Iterative Development 49

3.5.2.3 V-Shaped Model 50

3.5.2.4 Spiral Model 51

3.5.2.5 Extreme Programming 52

3.5.3 System Specifications 54

3.6 System Design 55

3.6.1 UML Basics An introduction to the Unified Modeling Language 55

3.6.1.1 Unified Modeling Language Use Case Diagrams 56

3.6.1.1.1 Use-Case Diagram 56

3.6.1.1.2 Class Diagram 60

 3.6.1.1.3 Sequence Diagram 60

3.6.1.1.4 State Chart Diagram 60

3.6.1.1.5 Activity Diagram 60

3.6.1.1.6 Component Diagram 61

3.6.1.1.7 Deployment Diagram 61

3.7 Database Analysis and table design 61

3.7.1 Database Objects 61

3.7.2 Database tables 63

3.7.2.1 Employer registration table. 63

3.7.2.2 Employee table 64

3.7.2.3 Enrollee table 64

3.7.2.4 Health Care Provider table: 66

3.7.2.5 HMO table: 66

3.7.2.6 Pharmacy table 67

3.7.2.7 Id Card table 68

3.7.2.8 Registration table. 69

3.7.2.9 Referral 70

3.7.2.10 Attendance table: 70

3.7.2.11 Health Care Providers 71

3.7.2.12 Acknowledgement table: 71

3.7.2.13 Change of Health Care Provider: 71

3.7.2.14 Admin Login Table: 72

3.7.3 Database Forms 74

3.7.3.1 Registration of Accredited NHIS Health Care Provider 74

3.7.3.2 Acknowledgement Slip 75

3.7.3.3 Add Staff 75

3.7.3.4 Login Form For Users 76

3.7.3.5 Attendance Form 76

3.7.3.6 Adverse drug reaction reporting form 77

3.7.3.7 Registration Of Accredited NHIS Health Management Organization 78

3.7.3.8 Tertiary Institution Registration Form 79

3.7.3.9 Top down Architectural design of the system 80

3.7.3.10 System Flow Chart 81

3.7.3.11 Architectural view of the implemented system 82

CHAPTER FOUR

SYSTEM IMPLEMENTATION AND TESTING

4.1a System implementation: 84

4.1b System requirements 84

4.2 Software tools 84

4.2.1 System Software or Operating System 85

4.2.2 Applications Software 85

4.2.2.1 Adobe Dream Weaver CS 5 85

4.2.2.2 Fireworks CS5 85

4.3 Hardware requirements 86

4.4 Portal form implementation: 86

4.4.1 Home Page implementation: 87

4.4.2 Users Login Page: 87

4.5 Working With the Menu Items 89

4.5.1 Page showing a pull down menu when the User Clicks Registration Menu item 89

4.5.2 Page displaying list of actions that is associated with the MHO menu item 90

4.5.3 Page for selecting the category and the corresponding existing HMO for modification 90

4.5.4 Page for selecting the category of HMO to modify 91

4.5. 5 Page that selected the category and the corresponding HMO for modification 91

4.5.6 Page that is used to add or register new HMO menu item 92

4.5.7 Page used to view list of registered HMOs 93

4.5.8 Page used for registration of new employers 93

4.5.9 Page for viewing list of registered employers 94

4.5.10 Page for viewing registered health care providers 94

4.5.11 Page for registering new health care providers 95

4.5.12 Page used for quarterly registered enrolees 95

4.5.13 Page used for registering new enrolees 96

4.5.14 Attendance page 96

4.5.15 Referral page 97

4.5.16 Acknowledgement page 97

4.5.17 Adverse drug reaction page 98

4.5.18 Page used to search or check for whether a health care or HMO is registered with NHIS 98

4.5.19 Page for preparing identity card for registered enrollees 99

4.5.20 Page displaying an enrollee whose identity card is to replaced 100

4.5.21 Page for adding new staff 100

4.5.22 Pharmacy recommendation page for handling the adverse drug reaction case 101

4.5.23 Page for processing new identity card 102

4.6 System testing: 102

CHAPTER FIVE

SUMMARY, RECOMMENDATIONS AND CONCLUSION

5.1 Summary 104

5.2 Limitations of this project: 105

5.3 Suggestions for further studies: 106

5.4 Recommendations: 106

5.5 Bill of engineering measurement and evaluation 108

5.6 Conclusion 108

Bibliography 110

Appendix A 113

Appendix B 115

Appendix C 118

Appendix D 122

Appendix E 124

Appendix F 140