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TABLE OF CONTENTS

Title Page – – – – – – – – – – i
Approval page – – – – – – – – – ii
Certification – – – – – – – – – iii
DECLARATION – – – – – – – – – iv
Dedication – – – – – – – – – v
Acknowledgement – – – – – – – – vi
Abstract – – – – – – – – – – vii
Table of Content – – – – – – – – viii
1.1 Background of the Study – – – – – – 1
1.2 Statement of Problem- – – – – – – 4
1.3 Objectives of the Study – – – – – – 5
1.4 Significance of the Study – – – – – – 6
1.5 1.5 Scope of the Study – – – – – – 7
1.6 1.6 Limitations of Study- – – – – – – 8
CHAPTER TWO
2.1 Review of Health Insurance Scheme – – – – 9
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2.2 History and Evolution of Health Insurance – – 10
2.2.1 Historical Overview of NHIS in Nigeria – – – 12
2.3 Overview of e-Health – – – – – – – 15
2.4 ICT in Health Service Delivery – – – – – 20
2.4.1 Old technologies – – – – – – – 21
2.4.2 New and convergent technologies – – – – 22
2.4.3 Health research – – – – – – – 22
2.4.4 Community-based health – – – – – – 23
2.4.5 Telemedicine – – – – – – – – 24
2.4.6 E-learning – – – – – – – – 25
2.5 Important Landmarks of ICT in Health Services – 26
2.5.1 Information and knowledge management – – – 27
2.5.2 Health management information systems – – – 28
2.5.3 Health campaigns – – – – – – – 30
2.6 Health care delivery system in United Kingdom (UK) – 31
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2.7 Some common Internet protocols – – – – 33
CHAPTER THREE
3.1 Fact Finding Methods – – – – – – 35
3.1.1 Primary Sources – – – – – – – 35
3.1.2 Secondary Sources – – – – – – – 36
3.1.3 Tertiary Source – – – – – – – – 37
3.2 Analysis of Existing System- – – – – – 37
3.2.1 Organizational Structure of NHIS – – – – 37
3.2.1.1 Government – – – – – – – 38
3.2.1.2 Employees – – – – – – – 38
3.2.1.3 Employers – – – – – – – 38
3.2.1.4 Other Contributors – – – – – – 39
3.2.1.5 Health Maintenance Organizations – – – 39
3.2.1.6 Board of Trustees (BOTs) – – – – – 40
3.2.1.7 Healthcare Providers – – – – – – 40
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3.2.1.8 Other Stakeholders – – – – – – 42
3.2.2 NHIS Registration Procedure – – – – – 44
3.2.2.1 Input Process – – – – – – – 44
3.3 Limitations of the Existing System – – – – 46
3.4 Proposed Solution to the Problems of the
Existing system – – – – – – – 46
3.5 Web Engineering process Model – – – – – 47
3.5.1 FORMULATION – – – – – – – 48
3.5.2 PLANNING – – – – – – – – 50
3.5.2.1 INDENTIFICATION OF PROJECT RISKS – – 50
3.5.2.2PROJECTSCHEDULING – – – – – – 52
3.2.2.3 COST ESTIMATION – – – – – – 55
3.6 Analysis – – – – – – – – – 58
3.6.1 Content Analysis – – – – – – – 58
3.6.2 Interaction Analysis – – – – – – – 59
3.6.3 Configuration Analysis – – – – – – 61
3.7 The New System design – – – – – – 61
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3.7.1 Design and Development of the System – – – 61
3.7.2 Functional Diagram – – – – – – – 62
3.7.3 Data Flow Diagram – – – – – – – 63
3.7.4 Context diagram – – – – – – – 64
3.7.4.1 DFD level 0 for HMO Registration – – – – 65
3.7.4.2 DFD level 0 for HSP Registration – – – – 66
3.7.4.3 DFD level 0 for Enrollee Registration – – – 67
3.8 Database Design – – – – – – – – 68
3.8.1 Entity Relationship Diagram (ERDM) – – – 68
3.8.2 Designing the ERD – – – – – – – 69
4.6.3 Entity Relationship Diagram – – – – – 70
3.9 Some Models of Data Design – – – – – 72
3.9.1 Conceptual Model of Data – – – – – 72
3.9.2 Logical Data Model – – – – – – – 74
3.9.3 Data Dictionary – – – – – – – 75
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3.9.4 Physical Data Model (PDM) – – – – – 77
3.10 TESTING AND PAGE GENERATION – – – – 80
3.10.1 Introduction – – – – – – – 80
3.10.2 Unit testing – – – – – – – – 80
3.10.3 Integration testing – – – – – – – 81
3.10.4 Validation testing – – – – – – – 82
3.10.5 Black Box testing – – – – – – – 82
3.10.6 Page Generation – – – – – – – 83
3.11 Customer Evaluation/Packaging and
Submission of Project – – – – – – 83
CHAPTER FOUR
4.1 Functional Versus Non – Requirements – – – 84
4.2 User Requirements Specifications – – – – 85
4.3 System Implementation – – – – – – 85
4.3.1 Implementation and testing overview – – – 85
xiv
4.3.2 System implementation – – – – – – 86
4.3.3 Description of tools used – – – – – – 86
4.3.3.1 Wamp Server- – – – – – – – 86
4.3.3.2 HTML – – – – – – – – – 87
4.3.2.3 Macromedia Dreamweaver – – – – – 87
4.3.3.4 MySQL – – – – – – – – – 87
4.3.3.5 Apache – – – – – – – – – 88
4.3.3.6 PhpMyAdmin – – – – – – – 88
4.3.4 Client-server Interaction – – – – – – 91
4.3.4.1 Characteristics of Clients and Servers – – – 91
4.3.4.2 The client Server Architecture – – – – 92
4.4 Some User Interface Screenshots – – – – 93
4.4.1 Home page screenshot – – – – – – 94
4.4.2 Enrollee Registration Page – – – – – – 95
4.4.3 List of Accredited HMOs – – – – – – 97
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4.4.4 List of Health Care Testers – – – – – 98
CHAPTER FIVE
5.1 Summary – – – – – – – – – 99
5.1.1 Achievements – – – – – – – – 100
5.3 Problems Encountered – – – – – – 100
5.3 Recommendations – – – – – – – 101
6.4 Conclusion – – – – – – – – 101
References
Appendix

CHAPTER ONE

INTRODUCTION
1.1 Background of the Study
Health insurance is insurance against the risk of incurring medical
expenses among individuals. By estimating the overall risk of health
care and health system expenses, among a targeted group, an
insurer can develop a routine finance structure, such as a monthly
premium or payroll tax, to ensure that money is available to pay for
the health care benefits specified in the insurance agreement. The
benefit is administered by a central organization such as a
government agency, private business, or not-for-profit entity.
According to the Health Insurance Association of America, health
insurance is defined as “coverage that provides for the payments of
benefits as a result of sickness or injury. Includes insurance for
losses from accident, medical expense, disability, or accidental
death and dismemberment” (Gary Caxton, 2008).
The National Health Insurance Scheme (NHIS) of Nigeria was
established through Act 35 of 1999 to provide health insurance for
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all Nigerians. The National Health Insurance Scheme – Millennium
Development Goals/Maternal and Child Health (NHIS –
MDGs/MCH) Project addresses Nigeria’s critical problem of poor
access to health care services for pregnant women and children
under the age of 5 (NHIS, 2014).
Phase 1 covered six Nigerian states (Sokoto, Niger, Gombe, Oyo,
Imo and Bayelsa); Phase 2 covered a further six states (Katsina,
Jigawa, Yobe, Bauchi, Ondo, and Cross River). So far in Phases 1
and 2 of the project, a total number of 1,545,646 pregnant women
and children were covered as at March 2011. Of this figure
1,193,893 are still accessing care while 351,753 have exited the
Project i.e. delivered or are above 5 years of age (NHIS, 2014).
Public or Government health facilities were used due to their
availability in rural areas and to ensure health funding at that level.
The health service package covers primary and secondary care for
pregnant women and only primary care for children; payment to
health providers is by Capitation and Fee for Service through Health
Management Organizations (HMOs). The source of funding for the
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Project is the Debt Relief Gains (DRGs) through the MDG funds and
Federal Government of Nigeria (FGN) appropriations (NHIS, 2014).
The objectives of the Nigerian NHIS are mainly
1. To ensure that every Nigerian has access to good healthcare
services.
2. To solve the problem of inappropriate use of levels of
healthcare, leading to unnecessary cost and under-utilization
of specialized facilities ensuring equitable patronage of all
levels of health care.
3. To improve and harness private sector participation in health
care service delivery and to ensure institutional quality
assurance.
4. Protect families from the financial hardship of huge medical
bills
5. To ensure equitable distribution of healthcare cost among
different income groups
6. Limiting the rise in the cost of healthcare service
7. To maintain high standard of healthcare delivery services
within the scheme.
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8. To ensure availability of funds to the health sector for
improved services and foster research in the health sector.
9. To ensure efficiency in healthcare services
10.To ensure adequate distribution of health facilities within the
federation( D. Adesina, 2009)
However, the national health insurance scheme is yet to effectively
actualize the above objectives and is currently facing a lot of
challenges (R. Abati, 2010)
This study is geared towards developing an online portal for the
scheme to register members and have a well-structured data
storage system, which makes it flexible for maintenance and
management.
1.2 Statement of Problem
Most of the Nigerian health insurance is presently using manual
system in their data processing; this involves the use of people,
pens and papers in records keeping. This method of data processing
reveals a number of problems which includes:
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· Records to be kept in health insurance system are often too
large, diversified and complex to be processed manually.
· The record maintenance and operations required on a day-today
basis are extensive.
· Varieties of services carried out in different departments
necessitate considerable efforts to ensure that all transactions
are taken into proper account.
· A lot of files are kept in the office that locating a particular
record at times takes a whole lot of time.
· People have to visit the health insurance offices before they
can get useful information.
Information can be lost when records are stolen, misplaced or
vandalized
1.3 Objectives of the Study
The objective of this project is to develop a web based information
Management system for National Health Insurance Scheme. The
new system will be able to do the following:
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(i) Provide Online Registration Processing for the enrolees.
(ii) Do an on-Line accreditation of Health Maintenance
Organizations (HMOs)
(iii) Also do an on-Line Publication of HMOs List
(iv) Provide an on – Line listing of Health care providers.
(v) Provide an on-Line access to change of health service
providers to another
(vi) Build a database of all the HMOs and Health providers
(vii) Build a database for the ministries that are registered for the
scheme
(viii) Maintain a database security for the National Health
Insurance Scheme (NHIS)
1.4 Significance of the Study
The following are the benefits of developing a web based
Management Information System for the National Health Insurance
Scheme:
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· Companies are able to highlight their strengths and
weaknesses due to the presence of revenue reports, employees’
performance record etc. The identification of these aspects can
help the company improve their business processes and
operations.
· Giving an overall picture of the company and acting as a
communication and planning tool.
· The availability of the customer data and feedback can help
the company to align their business processes according to the
needs of the customers. The effective management of customer
data can help the company to perform direct marketing and
promotion activities.
1.6 Scope of the Study
The scope of this study stops with re-engineering information
system with respect to registrations and health care management in
National Health Insurance Scheme through an online application.
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1.6 Limitations of Study
This research work is limited on administering the insurance
scheme which takes proper records of people enrolled in the
scheme, their health providers and the HMOs. Funding of the
scheme and financial accounting in the system is not covered in
this research.
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