The SIJ Transactions on Computer Science Engineering & its Applications (CSEA), Vol. 2, No.

4, June 2014
ISSN: 2321-2381 2014 | Published by The Standard International Journals (The SIJ) 141



AbstractAvailable evidences in the literature show that the rate of maternal mortality is high in the world
especially in developing countries. In this paper, the Online Antenatal Consultation System was developed
based on the Unified Modeling Language (UML) and web engineering approach to provide medical services to
the needy once in remote locations especially developing countries. The Online Antenatal Consultation System
was pilot tested in some selected remote locations. The results obtained indicated that the system is effective,
robust, and can effectively be utilized for the delivery of medical services to the needy populace in remote
locations. The Online Antenatal Consultation System developed in the study has the potentials of reducing
maternal mortality, which in turn can improve the health status of the rural women, thereby increases life
expectancy.
KeywordsAntenatal Consultation System; Online; Unified Modeling Language; Web Engineering.
AbbreviationsModified Prototyping Method (MPM); Unified Modeling Language (UML); UML Web
Engineering (UWE).

I. INTRODUCTION
N developing countries, web-based applications and
network-based medical systems such as online antenatal
consultation is critical for delivering medical services in
remote location. 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
Programme, 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 programmes and systems are
needed which must ensure effective health measures and
inexpensive community based interventions in public and
private sectors [Sule & Onayade, 2006].
1.1. Current Medical Trend in Nigeria
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
I
*Computer Science Department, Federal College of Education (Technical), P.M.B 60 Gombe NIGERIA.
E-Mail: aliakko{at}yahoo{dot}com, aliakko2000{at}gmail{dot}com
**Mathematical Sciences Programme, Abubakar Tafawa Balewa University, P.M.B 248, Bauchi NIGERIA.
E-Mail: bsouley2001{at}yahoo{dot}com
Ali Muhammad Usman* & Boukari Souley**
Online Antenatal Consultation System
based on UML and Web Engineering
Approach
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ISSN: 2321-2381 2014 | Published by The Standard International Journals (The SIJ) 142
1,000 live births, compared to 153 per 1,000 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].
1.2. Research Questions
This research intends to answer the following questions:
How does the design methodology of this research
work differ with the previous telemedicine with
reference to antenatal care?
How does the implementation of previous work
coincide and differs with the web engineering
approach proposed in this research?
To what extent this research work can reduce the rate
of maternal and infant mortality rate in a cost effective
way?
II. METHODOLOGY
2.1. Evolution of the Web and its Applications
The Web has evolved beyond anyones imagination within a
short span of 15 years, since conceived and publicized as a
system for turning the Internet into a publishing medium for
sharing and dissemination of scientific data and information.
It has become indispensable and essential to many people and
organizations around the world [Tim, 1991; Gustavo et al.,
2006].
The evolution of the Web has brought together about the
successful use of ubiquitous computing; using a variety of
devices such as; desktop and notebook computers pocket
PCs, personal digital assistants (PDAs), and mobile phones
to share information among users. The evolution of the Web
could be traced and discussed along a few different
dimensions and from a few different perspectives: the growth
(number) of Web sites and Web pages, the number of Web
users, the number of Web visits, the functionality and
interactivity that Web applications offer, the technologies
used for the creation of Web applications, the social and
business impact of the Web, or a combination of any of these
perspectives [Gustavo et al., 2006; Murugesan, 2007;
Abubakar et al., 2013B].
2.2. Classification of the Web
A classification of Web is diagrammatically shown in figure
2.1 below:

Figure 2.1: Classification of Web [Adopted from Murugesan, 2007]
2.2.1. The Shallow Web (Web 1.0)
The Shallow Web, also known as the Static Web, is primarily
a collection of static HTML Web pages providing
information about products or services offered. To start with,
most Web sites were just a collection of static Web pages.
After a while, the Web became dynamic, delivering Web
pages created on the fly. The ability to create Web pages
from the content stored on databases enabled Web developers
to provide customized information to visitors. These sites are
known as the Deep Web, or the Dynamic Web. Though a
visitor to such Web sites gets information tuned to his or her
requirements, these sites provide primarily one-way
interaction and limited user interactivity. The users have no
role in content generation and no means to access content
without visiting the sites concerned. The Shallow Websites
and Deep Web sites, which have no or very little user
interaction, are now generally termed as Web 1.0 [Gustavo et
al., 2006; Murugesan, 2007].
2.2.2. The New Face of the Web (Web 2.0)
In the last few years a new class of Web applications, known
as Web 2.0 (or Service-Oriented Applications), has emerged.
These applications let people collaborate and share
information online in seemingly new ways; examples include
social networking sites such as facebook.com, media sharing
sites such as youtube.com, and collaborative authoring sites
such as wikipedia.com.
The new (second) generation Web, also known as the
Wisdom Web, the People-Centric Web, and the Read/Write
Web, offers smart user interfaces and built-in facilities for
users to generate and edit content presented on the Web and
thereby enrich its content. Besides leveraging the users
potential in generating content, Web 2.0 applications provide
facilities to keep the content under the users own categories
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(tagging feature) and access it easily (Web feed tool). These
new breeds of Web applications are also able to integrate
multiple services under a rich user interface [Levy & Stone,
2006].
With the incorporation of new Web technologies such as
Asynchronous JavaScript and XML (AJAX), Ruby, blog,
wiki, social bookmarking, and tagging, the Web is fast
becoming more dynamic and highly interactive, where users
can not only pick content from a site but can also contribute
to it. The Web feed technology allows users to keep up with a
sites latest content without having to visit it. Another feature
of the new Web is the proliferation of Web sites with
Application Programming Interfaces (API). An API from a
Web service facilitates Web developers in collecting data
from the service and creating new online applications based
on these. The Web 2.0 is a collection of technologies,
business strategies, and social trends. It is a highly
interactive, dynamic application platform than its
predecessor, Web 1.0, for fielding new kinds of applications.
Recently, a wide array of Web 2.0 applications has been
launched [OReilly, 2005; OReilly, 2006; Murugesan, 2007].
2.2.3. Mobile Web
Advances in mobile computing, wireless communications
and widespread of mobile devices, such as smart mobile
phones, PDAs, and Pocket PCs, are enabling a growing
number of users to access the Web using handheld devices.
Mobile phones may soon challenge personal computers as the
dominant platform for accessing the Web/Internet. In Ipsos,
(2006), it was observed that 28% of mobile phone owners
worldwide browsed the Internet on a wireless handset in
2005, up from 25% in 2004. Almost all wireless device
activities such as information access and search, mobile
commerce (i.e., purchasing a product or service via a mobile
device), conducting financial transactions, mobile ticketing
among others experienced growth in 2005. Accessing the
Internet on a wireless handheld device is becoming a
common everyday occurrence for many people in some
advanced and developing countries. This will become
increasingly prevalent as high-end (smart) mobile phones and
Pocket PCs become affordable. Higher numbers of people
start using these more capable handheld devices, and many
Web applications migrate to the wireless/mobile Web.
Considering the adoption of mobile Web and its huge
potential, the World Wide Web Consortium has established a
new initiative called the Mobile Web. Mobile Web
applications could offer some additional features compared to
traditional desktop Web applications such as location-aware
services, context-aware capabilities, and personalization.
Mobile Web applications have, however, some unique
requirements and pose additional challenges [Murugesan,
2007; Mantoro et al., 2012; Abubakar et al., 2014].
2.2.4. The Semantic Web
In the current Web applications, information is presented in
natural language, which humans can process easily. But
computers cant manipulate natural language information on
the Web meaningfully. The Semantic Web aims at
overcoming this barrier. The Semantic Web is an extension of
the current Web in which information is given a well-defined
meaning, better enabling computers and people to work in
cooperation. It intends to create a universal medium for
information exchange by putting documents with computer
process-able meaning (semantics) on the Web. Adding
semantics radically change the nature of the Web from a
place where information is merely displayed to one where it
is interpreted, exchanged, and processed. Associating
meaning with content or establishing a layer of machine
understandable data enables a higher degree of automation
and more intelligent applications and also facilitates
interoperable services [Berners-Lee et al., 2001].
The ultimate goal of the Semantic Web is to support
machine facilitated global information exchange in a scalable,
adaptable and extensible manner. Thus, information on the
Web can be used for more effective discovery, automation,
integration, and reuse across various applications. The three
key ingredients that constitute the Semantic Web and help
achieve its goals are semantic markup, ontology, and
intelligent software agents [Berners-Lee et al., 2001;
Antoniou & Harmelen, 2004; Shadbolt, 2006].
2.3. Modified Prototype Method
The prototyping method was formally introduced to the
Information Systems community in the early 1980s to combat
the weakness of the traditional waterfall model [Naumann &
Jenkins, 1982]. It is an iterative process of system
development. Working closely with users, developers design
and build a scaled-down functional model of a desired
system. The developer demonstrates the working model to
the user and then continues to develop the prototype based on
the feedback received by the developer and the user agree
that the prototype is good enough. At that point, the
developer both throws away the prototype and starts building
the real or completes any remaining work on the prototype
and releases the prototype as a final product (evolutionary
prototype). Figure 2.2 illustrates the evolutionary prototyping
process. The maintenance phase begins only after the final
system is formally deployed. The prototyping method has
gained its popularity because of its ability to capture user
requirements in concrete form.

Figure 2.2: The Evolutionary Prototyping Method [Adopted from
Woojong, 2005]
In fact, the method is often used for designing decision
support systems when neither the decision maker nor the
system designer understands the information requirements
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well. It is often used along with traditional system
development methods to speed up the system development
process. Another related method is the staged delivery in
which the project is divided into several stages. Each stage
consists of detailed design, code, debug, and delivery of a
component of a desired system. Like an evolutionary
prototyping method, it has a distinctive boundary between
development and maintenance. These methods have been
proven very successful when customized for specific
development environments for non Web-based application
development. They are also applicable to Web-based
applications. In fact, prototyping methods are especially
suitable for Web based applications because of the ease of
system delivery and updates afforded by Web technology.
However, the unique requirements of Web applications
require the designers to take additional considerations when
using these models. MPM allows for basic functionality of a
desired system or a component of it to be formally deployed
right away. The maintenance phase is set to begin right after
the deployment. The method is flexible enough not to force
an application to be based on the state of an organization at a
given time. As the organization grows and environment
changes the application changes with it rather than being
frozen in place [Woojong, 2005].
2.4. Web Engineering
Web Engineering seeks to address the problem of Web
application development by building a foundation for the
systematic creation of Web-based systems. This foundation
will consist of a body of theoretical and empirical knowledge
for development, deployment, and support of the continual
evolution of Web applications [Gustavo et al., 2006].
A Web-based system is just like a living system it grows,
evolves, and changes. An appropriate infrastructure is
necessary to support the growth of a Web-based system in a
flexible and controlled manner. Web Engineering helps to
create an infrastructure that will allow evolution and
maintenance of a Web system and also support creativity.
Web Engineering is concerned with the development and
organization of new knowledge about web application
development; application of that knowledge to develop web
applications that address new requirements and challenges
facing web developers [Kappel et al., 2006].
Web Engineering could also be viewed as a holistic and
proactive approach to the development of complex Web-
based systems. In a holistic approach, all aspects of the
development processes, functional requirements, the
applications operational environment, the supporting IT and
other infrastructure, and the linkages and interactions among
them are identified, analyzed, prioritized, implemented, and
evaluated. It is important for developers to understand the
wider context in which a Web-based system or application
will be used, and design an architecture that will support the
development, operation and maintenance as well as the
evolution of the Web application in that context, addressing
the key issues and considerations [Ginige & Murugesan,
2001].
Web development is a process, not simply a one-time
event. Thus, Web Engineering deals with all aspects of Web-
based systems development, starting from conception and
development to implementation, performance evaluation, and
continual maintenance. Web Engineering, therefore, covers a
range of areas: requirements elicitation and analysis; Web
system modeling; Web architecture; Web system design;
Web page design; scripting/coding; interface with databases,
Enterprise Resource Planning (ERP) systems, and other Web-
based systems; Web quality; Web usability; Web security;
Web system performance evaluation; Web testing; Web
development methodologies; Web development process; Web
metrics; and Web project management [Murugesan, 2007].
The nature, characteristics and development of Web-
based applications demand Web Engineering to be
multidisciplinary, encompassing inputs from diverse areas
such as systems analysis and design, software engineering,
hypermedia/hypertext engineering, requirements engineering,
human-computer interaction, user interface, information
engineering, information indexing and retrieval, testing,
modeling and simulation, project management, graphic
design and presentation [Deshpande et al., 2002].
2.4.1. UML-Based Web Engineering
UML-based Web Engineering (UWE) came up at the end of
the 1990s [Baumeister et al., 1999; Wirsing et al., 1999] with
the idea to find a standard way for building analysis and
design models of Web systems based on the then-current
methods of Object-Oriented Hypermedia Design Model
OOHDM [Schwabe & Rossi, 1995], Relationship
Management Methodology RMM [Isakowitz et al., 1995],
and Web Site Design Method WSDM [Troyler & Leune,
1998]. The aim, which is still being pursued, was to use a
common language or at least to define a meta - model based
mappings among the existing approaches [Koch & Kraus,
2002; Escalona & Koch, 2006]. At that time the Unified
Modeling Language (UML), which evolved from the
integration of the three different modeling techniques of
Booch, Object Oriented Software Engineering OOSE, and
OMT, seemed to be a promising approach for system
modeling [Koch et al., 2008].
Since those early integration efforts, UML has become
the lingua Franca of OOSE [Object Management Group,
2005]. A prominent feature of UML is that it provides a set of
helps for the definition of Domain-Specific modeling
Languages (DSL) so called extension mechanisms.
Moreover, the newly defined DSLs remain UML-compliant,
which allows the use of all UML features supplemented, such
as with Web specific extensions. Both the acceptance of the
UML as a standard in the development of software systems
and the flexibility provided by the extension mechanisms are
the reasons for the choice of the Unified Modeling Language
instead of the use of proprietary modeling techniques. The
idea followed by UML Web Engineering (UWE) to adhere to
standards is not limited to UML. UWE also uses XML data
Interchange (XMI) as a model exchange format (in the hopes
of future tool interoperability enabled by a truly portable
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XMI), for meta-modeling, the model-driven principles given
by OMGs Model-Driven Architecture (MDA) approach, the
transformation language, and extensible Markup Language
(XML). UWE is continually adapting, on the one hand, two
new features of Web systems, such as more transaction-
based, personalized, context-dependent, and asynchronous
applications. On the other hand, UWE evolves to incorporate
the state of the art of software engineering techniques, such
as aspect-oriented modeling, integration of model checking
using Hugo/RT [Koch et al., 2008; Gustavo et al., 2006].
2.4.2. Modeling with UML
The only distinguishing feature of UWE is its UML
compliance since the model elements of UWE are defined in
terms of a UML profile and as an extension of the UML
meta-model [Koch & Kraus, 2002]. Although the UML is
expressive enough to model all requirements that arise in
modeling Web systems, but it does not offer Web domain-
specific elements. To simplify modeling of the special
aspects of Web applications, we define in UWE special views
using UMLs extension mechanisms graphically represented
by UML diagrams, such as the navigation model and the
presentation model [Koch et al., 2008]. UML modeling
techniques comprise of construction of the static and dynamic
views of the software systems by object and class diagrams,
component and deployment diagrams, use case diagrams,
state and activity diagrams, sequence and communication
diagrams. The UML extension mechanisms are used to define
stereotypes that we utilize for the representation of Web
constructs, such as nodes and links. In addition, tag
definitions and constraints written in OCL (Object Constraint
Language) can be used. This way we obtain a UML
compliant notation a so-called UML lightweight extension or
better known as a UML profile. UWE notation is defined as
such a UML profile [Gustavo et al., 2006; Koch et al., 2008;
Zeki et al., 2013].
The advantage of using UML diagrams is the common
understanding of these diagrams. Furthermore, the notation
and the semantics of the modeling elements of pure UML,
i.e., those modeling elements that comprise the UML meta-
model, are widely described in the OMG documentation
[Object Management Group, 2005]. For any software
designer with a UML background, it is easy to understand a
model based on a UML profile, such as the extension that
UWE suggests. We observe that UML extensions inherit
the problems of UML, e.g., the lack of a complete formal
semantics covering all modeling elements. UWE focuses on
visual modeling together with system design and automatic
generation. The aim is to cover the entire development life
cycle of Web systems, providing techniques and notations to
start with requirements models, moving through design
models, as well as including architecture and aspect models.
All these models are visualized using UML diagrammatic
techniques [Gustavo et al., 2006; Koch et al., 2008].
III. OBJECT ORIENTED SYSTEM ANALYSIS
AND DESIGN
3.1. System Analysis and Modeling
During analysis the developer's aim is to produce a model of
the system that is correct, complete, consistent, unambiguous,
realistic and verifiable. The use cases produced during
requirement elicitation are presented. The system is proposed
to cover Gombe, Kwami and Funakaye Federal constituency.
The choice is made to enable the researcher conduct
extensive requirement engineering. Federal Teaching
Hospital Gombe (FTHG) will serve as the center where the
server will be deployed. The expert physicians normally stay
at the FTHG where nurses in the other remote areas as well as
specialist hospitals will be contacting them.
3.2. Analysis of the Proposed System
The first step toward developing a Web system is the
identification of the requirements for such an application that
are specified in UWE with a requirement model. UWE
proposes two levels of granularity when modeling Web
system requirements. First, a rough description of the
functionalities is produced, which are modeled with UML use
cases. In a second step, a more detailed description of the use
cases is developed by using UML activity diagrams that
depict the responsibilities and activities of the stakeholders
[Koch et al., 2008]. In this case detailed view of Use case is
presented which includes actors, pre- and post conditions, a
workflow description and the exception error situation among
others. Here the existing system is analyzed and hence the
new system is proposed based on the existing system
requirement.
Using UML as a modeling tool the general use case for
the proposed system is given in figure 3.1 below. The use
case diagrams present the major component units that interact
with the user. For the Online Antenatal Consultation System
(OACS) the Doctor, Nurse, Patient and Administrator are the
actors that interact with the system.

Figure 3.1: Use Case Diagrams for OACS

O A C S
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IV. RESULTS AND DISCUSSION
In modeling the OACS, the use case diagram, activity
diagram, swim lane diagram and the class diagram that are
used in implementing the OACS are presented below:
4.1. Use Case Diagrams
4.1.1. Doctors Use Case

Figure 4.1: Doctors Use Case
This use case is activated by the Doctor. It provides the
capability to prescribe drugs and online consultation. The
precondition requires that Doctor must be registered by
receiving pin from the administrator and receives an alert that
he is booked by some patient against him. The flow of the
events is:
The Doctor must log on to OACS by typing his user
name and password which are being verified [E1:
Invalid password] via the OACS.
The Doctor can check the patients record in order to
prescribe and diagnose appropriately, if the patient
need online consultation, then the Doctor will appoint
a time for their meeting including the Nurse(s) at the
station and drop his Skype ID.
The Nurse will call the Doctors Skype ID for online
consultation and
The Doctor will diagnose and prescribe appropriately
through online consultation, then record it in the
patient record.
The alternatives are: If the Doctor observed the need to
only prescribe drugs without online consultation the OACS
will do so through the Clinical Decision Support System
(CDSS) [A1: Only drugs prescription and advice]. Also, if
Doctor observed the need for online consultation based on the
patient record the OACS will enable room for that as well
[A2: Online consultation]. Similarly, if both alternatives are
required, then it should be handled by the OACS as well [A3:
Both prescription and online consultation] and the exception
from this Use Case is [E1: Invalid Password], the OACS will
cancel all operation and prompt the Doctor to re-enter user
name and password, once the password and the user name are
incorrect the OACS will deny the Doctor access to the system
finally, Doctor will record the prescription of drugs and
advices in the patient record database.



4.1.2. Nurse Use Case

Figure 4.2: Nurse Use Case
This use case is activated by the Nurse, CHEW, JCHWE
or CHO. It provides the capability to register and update
nurse and patients in the rural areas (pregnant women) and
online consultation with expert physicians. The Nurse must
be registered by the Administrator use case through a pin to
be issued (pre-condition). The normal flow of events is:
The Nurse log on to OACS by typing user name and
password which are being verified [E1: Invalid
password] via the OACS
The Nurse will register the patient if the patient is
coming for the first time then takes all the necessary
readings needed and record them in the patient record
[A1: New patient]
The Nurse will check the patient record and see what
the doctors recommend or prescribe [A2: Registered
patient] and print the form
The Nurse will call the Doctors Skype ID for online
consultation, and also if the need for emergency arises
and
All the Doctors diagnoses and prescription will be
saved in the patient record for further consideration
The alternative flows are:
The Nurse observed the need to print prescription
form filled by the doctor [A1: Print prescription form
and advice by the Doctor]
Nurse realizes that its an emergency case, then the
Nurse will call the Doctor on duty [A2: Online
consultation]
If both alternatives are required, then it should be
handled by the OACS as well [A3: Both prescription
and online consultation]. Exception that will be
thrown is [E1: Invalid Password], the OACS will
cancel all operations and prompt the Nurse to re-enter
user name and password, once the password and the
user name are incorrect the OACS will deny the Nurse
access to the system until the user name and password
are correct. The Nurse will ensure that the Doctor have
recorded the prescription of drugs and advices in the
patient record database (post-condition). The rule is
that Doctor is the only one to prescribe drugs to the
patient, unless in emergency cases where none of the
doctors on duty is available in that case the nurse is to
act appropriately and hence that is the constraint.
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ISSN: 2321-2381 2014 | Published by The Standard International Journals (The SIJ) 147
4.1.3. Patient Use Case

Figure 4.3: Patient Use Case
This Use Case is activated by the Patient (i.e. pregnant
woman). It provides the capability to book an appointment
with expert physicians. The pre-condition requires that the
patient must be registered by the Nurse/ Administrator Use
case before using the OACS. The normal flow of the events
is:
The Patient log on to OACS by typing user name and
password which are being verified [E1: Invalid
password] via the OACS or the Nurse will login for
the patient.
The Patient will check her appointment with an expert
physician and decide whether to meet the doctor alone
[A1: Online consultation with only patient] in this case
a link for Skype link will be sent to the patient to
register and finally the Doctors Skype ID will be sent
to her for the online consultation to take place and the
Doctor is expected here to record all necessary
information in the patient record.
The patient may also decide to meet the doctor with
the nurses at her station [A2: Online consultation with
Nurse and Patient] in this case only the Nurse is
having the Doctors Skype for the online consultation
and the Nurse is expected to record all necessary
information in the patient record.
There are two alternatives by the Patient Use Case these
are:
A1: Online consultation with only patient.
A2: Online consultation with Nurse and Patient. The
only exception is [E1: Invalid Password], the OACS
will cancel all operations and prompt the Patient to re-
enter user name and password, once the password and
the user name are incorrect the OACS will deny the
Patient access to the system until the user name and
password are correct.
4.1.4. Administrator Use Case

Figure 4.4: Administrator Use Case
This use case is activated by the Administrator. It
provides the capability to generate pins for registering all the
actors of the OACS, connect and diagnose network and create
slides, post notice and register clinic as well. The normal flow
of the event includes:
The Administrator log in by typing user name and
password which are being verified [E1: Invalid
password] via the OACS or register with a user name
and password ii.
The Administrator will ensure that the network
connection is strength enough to enable smooth
operation of the entire system and diagnose the
network where fault is noted
The Administrator will add slides, post notices,
register clinics and generate pins for registration
The administrator is also responsible for checking the
amount remaining in the modem and loading some if
the amount is finished or about to finish.
The only exception thrown here is [E1: Invalid
Password], the OACS will cancel all operations and prompt
the Administrator to re-enter user name and password, once
the password and the user name are incorrect the OACS will
deny the Administrator access to the system until the user
name and password are correct. In case the network signal is
weak or no funds to load into the modem, then OACS must
be suspended till they are all satisfy and hence the constraint.
4.2. Activity Diagram
When we follow the principle of using UML, we realize that
whenever possible for the specification, we refine
requirements with UML activity diagrams. For each
nontrivial business use, we built at least one activity diagram
for the main stream of tasks to be performed in order to
provide the functionality suggested by the corresponding use
case [Koch, 2006].
4.2.1. Doctors Activity Diagram
The activity diagram depicts the doctors flow of events. The
doctor must register with pin collected from the administrator
to obtain username and password. Login should be done with
only the username and password registered with. The doctor
can check patient records, prescribe drugs and save in the
patient record database as shown in figure 4.5 below:

Figure 4.5: Doctors Activity Diagram
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ISSN: 2321-2381 2014 | Published by The Standard International Journals (The SIJ) 148
4.2.2. Nurse Activity Diagram
The nurse (or any other health workers such as CHO, CHEW
OR JCHEW) must also register with a pin collected from the
administrator to obtain username and password. Login should
always be done with a valid username and password
registered with. The nurse can write to the doctor and check/
print prescribed drugs for patients in the rural areas as shown
in figure 4.6 below:

Figure 4.6: Nurse Activity Diagram
4.2.3. Administrator Activity Diagram
The administrator is responsible for diagnosing network
problem while OACS is taking place. The administrator must
login with a valid username and password. The duties
perform by the administrator include: generating pin, adding
clinic, posting notice and managing slides used by the OACS
as shown in figure 4.7 below:

Figure 4.7: Administrators Activity Diagram
4.2.4. Online Consultation
The nurse must login with a valid username and password
which is checked by the OACS. The nurse can check the
doctors Skype ID and call using Skype installed on their
laptop. The doctor can receive Skype call (which is free) and
communicate effectively. The doctor will diagnose the patient
online and prescribe drugs. The nurse will in turn print
prescription form. The doctor will finally record all findings
on the patient record using the OACS as shown in figure 4.8.

Figure 4.8: Swim Lane Activity Diagram for Online Consultation
with Nurse, Doctors and Patient same can be used in Emergency
Situations
4.3. Architectural Model of the OACS
The working of this basic model is as follows. The Nurse will
record all the necessary data to the patient electronic medical
record (database). The remote server will process the data,
invoke the Clinical Decision Support System (to be done by
the Doctors) to perform analysis of data, invoke the
Electronic Medical Record service that record in the patients
history and provide feedback to the nurse or the patient.

Figure 4.9: Basic Architectural Model for OACS [Adapted from
Muhammad et al., 2010]
The SIJ Transactions on Computer Science Engineering & its Applications (CSEA), Vol. 2, No. 4, June 2014
ISSN: 2321-2381 2014 | Published by The Standard International Journals (The SIJ) 149
4.4. Class based Diagram
This consists of classes that are used in implementing the online antenatal consultation system as shown in figure 4.10 below:

Figure 4.10: Class based Diagram
Four use case diagrams were developed and tested using
the UML editor and found compliance with UML notations.
Similarly, activity diagrams developed also are tested and
found that they are generating expected results. The model if
implemented will work on desktop computers, laptops and
mobile phones. However, the modem to be used in providing
internet connection may fail if poor network is detected from
the network providers.
V. CONCLUSIONS AND FUTURE WORK
A Model for Online Antenatal Consultation was developed
using Web Engineering Approach. Modified Prototyping
Method and UML Web-Based Engineering was used in
developing the models. However, if the OACS is
implemented, host and use effectively, it will help in reducing
the problems of maternal mortality in Nigeria. UWE is found
to be an effective way of obtaining user requirement and
developers will find it easy for implementation. The research
develops models for Online Antenatal Consultation using
Violet UML Editor other works should be done to implement
the models developed in this research using any web
engineering programming tools. We intend to use wireless
sensors [Usman et al., 2014A] and Internet of things [Usman
et al., 2014B] in the future to develop an antenatal healthcare
system that can be accessed anywhere and anytime.
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Ali Muhammad Usman is a lecturer at
Computer Science Department of Federal
College of Education (Technical) Gombe.
Nigeria. Ali obtained MSc in Computer
Science at Adamawa State University Mubi,
Nigeria, (2014). First degree in Computer
Science from Abubakar Tafawa Balewa
University Bauchi, Nigeria (2005). Post
Graduate Diploma in Education (Mathematics)
in 2008 from Usman Danfodio University Sokoto. Member Nigeria
Computer Society, member International Association of Engineers
and Member Teachers Registration Council of Nigeria. Have
numerous journal publications both in Nigeria and outside. His
research interests are; Web/Software Engineering, Computer
Programming, Database Management Systems, Artificial Neural
Network, Computer Forensic, and Computer Networking and
Security.
Dr. Boukari Souley holds B. Tech., M. Tech.
and Ph. D in Computer Science, from
Abubakar Tafawa Balewa University, Bauchi.
Boukari is a researcher in Mathematical
Sciences Programme (Computer Department),
Abubakar Tafawa Balewa, University,
Bauchi. He has graduated many
undergraduate and post graduate students. He
has published many articles in international
academic journals and conference proceedings. His research interest
include: Web/Software Engineering, Cloud Computing, Compiler
Construction Computer Networking and Security.