Software Architecture for Integrated Child Development...

© 2014, IJARCSSE All Rights Reserved Page | 493

Volume 4, Issue 5, May 2014 ISSN: 2277 128X

International Journal of Advanced Research in Computer Science and Software Engineering Research Paper Available online at: www.ijarcsse.com

Software Architecture for Integrated Child Development

Services (ICDS) – Nutrition & Health Services Abhilash CS

* Neha Kishnani

Prof. L.T. Jay Prakash

M.Tech Student, IIITB M.Tech Student, IIITB Department of Software Engg., IIITB

India India India

Abstract — This paper deals with the implementation of the Integrated Child Development Services (ICDS) software

model. It identifies and explains important architectural elements. Also, this paper will serve the needs of stakeholders

to understand system concepts and give a brief summary of the use of the ICDS system. It is identified that the existing

ICDS scheme is having issues with data management and implementation. Major part of India suffers from

malnutrition. Our architecture recognizes multi-dimensional nature of malnutrition and health issues related to kids

and reflects the software solution for the same in our implementation. The architecture uses the Zachman framework

to address the problem.

Keywords— ICDS, Zachman, AWW, Health card, GIS

I. INTRODUCTION

This paper provides a high level overview of the evolving technical architecture for the ICDS. It outlines the technologies

that ICDS members will use for broad collaboration and participation in a distributed network for healthcare system. In

facilitating interoperability through standards, ICDS will help its members enhance physician expertise, promote

professional collaboration, and raise the level of patient care. The paper provides a high-level description of the goals of

the architecture, the use cases support by the system and architectural styles and components that have been selected to

best achieve the use cases. This framework then allows for the development of the design criteria that define the technical

and domain standards in detail. It is these detailed design that will guide the development of the ICDS content in terms of

messages and services.

Managing health care information is a challenge with unique requirements, and so far, no system has been able to address

the complexity of the entire health care system. Data is incomplete, workflow is discontinuous, and management is not

uniform. Therefore, it has been government‟s dream to establish the Enterprise Healthcare Information System that could

integrate all heterogeneous systems and make all health care data including clinical report, lab results and medical images

available whenever and wherever they are needed. Specifically in this report we are discussing the software architecture

for ICDS (Integrated Child Development Scheme). The scheme involves gathering data about mothers and children

under 6. The scheme provides health and nutrition education, health services, supplementary food, immunization and

pre-school education to them. The ICDS national development program is one of the largest in the world. It reaches more

than 34 million children aged 0-6 years and 7 million pregnant and lactating mothers. India has 550.48 million mobile

users as per our India Mobile Landscape (IML) 2013 study. More than 290.8 million, about 54 percent, of these device

owners are in rural areas as compared to 250.6 million in cities and towns. On an average there are 1.2 (=1) mobile

phone/family.

II. LITERATURE REVIEW

Few software architectures follow agile development technology. Unfortunately, most agile processes reject and

discourage “big design up front.” In a nutshell, many agile processes and especially extreme programming reject the big

design phase as part and parcel of rejecting the waterfall methodology. Agile processes follow more of an “organic”

software development, where developers start coding the smallest increment possible and “grow” the working software

up, little by little, with constant customer feedback. These agile methodologies call for “user stories” to design each small

increment of the system being developed. A health care system like ICDS requires scalability, data integration, numerous

system interfaces and other complexities. In the agile methodology followed, a health care system is first developed for a

certain city and then extended further. This will affect the interoperability issue later. Thus scalability is not supported by

agile methodology.

III. PPROPOSED WORK

The proposed architecture assumes that adequate funding, resources and medicines supply are available to the village and

town Anganwadi workers (AWW) centers from the government for the successful implementation of the architecture.

A) Architecture Overview

AWWs work for 4 to 6 hours a day where they visit several houses, collect health care related data, provide basic health

services and education and return to their office/workplace and document the same. Our project pretends to provide each

http://www.ijarcsse.com/

Abhilash et al., International Journal of Advanced Research in Computer Science and Software Engineering 4(5),

May - 2014, pp. 493-501


AWW a mobile phone/PDA with a private and a public phone numbers. The patient may book an appointment with

his/her AWW when he/she needs. When AWW is not available the patient appointment is redirected to a centralized

server that provides the basis guiding for the patient and manages the AWW timetable (adding and removing patient

appointments). The AWW will have access to a drug database and our proposed system tends to be integrated with the

Pharmacies (Hospitals) Information Systems in order to allow online prescription. Another issue addressed in this project

is the patient clinical data integration between the mobile phone, the central system and the Public health-care

information systems (in the hospitals and in the primary health-care units).

B) Architectural Representation

We propose „ZACHMAN FRAMEWORK‟ architecture for our ICDS healthcare project. The process requires three

business services AWW appointment management, Patient clinical management, and drug prescription. The architecture

at the application level is presented in Fig. 1.

Fig.1 Overview of the proposed architecture

The Architecture shows various modules involved in the project. Mainly they are as follows:

Target user module

AWW (Anganwadi worker) module

AWW Centre module

SMS service module

Hospital module

Geographic Information System (GIS) tracking module

1) Target user module:

Architecture requires the government to provide each and every family a „Health Card‟, which carries basic information

about the target user, user‟s name, age, address, contact number, Aadhar card details, family income and free service

availability for the user. The module describes various services which a user can register to.

2) AWW (Anganwadi worker) module:

The module describes the basic classification of the anganwadi working system into primary and secondary AWWs. The

primary AWWs manage secondary AWWs and also the ASHA workers (out of scope of this paper). The primary AWWs

are stationed at AWW centre and manage the ICDS software system. District health commissioner manages primary

AWWs and provides training to them. Primary AWWs in turn are responsible to provide training to secondary AWW.

Secondary AWWs are also sub-divided into Nutrition based secondary AWWs and preschool based AWWs. They


May - 2014, pp. 493-501


provide the education (health, nutrition, pre-school) to the target users. Training can be classified as pre-school training,

malnutrition prevention / health education training which targets babies (age<6), children (age (6 to 14)), pregnant

woman and mothers. Primary AWW is having access to telemedicine van using which he visits each and every house

under his jurisdiction. Primary AWW can provide basic health check-up activity through the telemedicine van and

medical apparatus.

3) AWW Centre module:

AWW centre is where primary AWW is stationed and data entry/management takes place. Whenever the target user

requests for AWW visit/telemedicine van request, all the requests are processed in the server which has access to central

database and AWW centers are informed accordingly.

4) SMS service module:

Target users can initiate requests by using the mobile application (Smart phones)/ SMS (basic handset). The requests are

stored in central database and server sends notifications to respective AWW centers and hospitals depending on timer

function.

5) Hospital module:

The hospital module consists of services database containing the services available in various hospitals and medicine

distribution database which provide information of all the available medicine information and distribution data. Hospital

ambulance request can also be made by target user to the hospital module via SMS module.

6) GIS tracking module:

The GIS (Geographic Information System) consists of various maps and map related databases which help to track the

path (visit) coverage of secondary AWW. It can be monitored by primary AWW and district commissioner. Even the

secondary AWW can make use of GIS database to plan his visits and revisits to various houses in his town.

C) USE CASE Diagrams The Use case diagrams depict common use cases the target users, hospitals, SMS module, primary & secondary AWWs

may perform with the ICDS software architecture. Various actors and their use cases in the architecture are represented

as follows:

Target user Primary AWW

Fig. 2 Use case diagram of target users Fig. 3 Use case diagram of primary AWW


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Secondary AWW SMS application

Fig.4 Use case diagram of secondary AWW Fig. 5 Use case diagram of SMS application

Hospital

Fig. 6 Use case diagram of Hospital

D) Mobile interfaces:

Fig. 7 Mobile interface used by people who are availing ICDS


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Fig.8 Mobile interface used by secondary AWW

The mobile interface designed for target audience (end users/people) is shown in Fig. 7 and the mobile interface designed

for secondary AWW is shown in Fig. 8

E) Prevention of misuse of ICDS benefits

It has been noted that the health care facilities and special benefits are often misused by people. Benefits such as free

medicinal care, which are meant only for economically poor class are often misused by middle brokers (AWW or health

care personals) by selling it in black market for a higher price causing an „out of stock‟ situation in the required areas.

The funds granted for health care units are also misused and false reports are produced. In few cases, it is noticed that

people would be using the benefits that were meant to a person, who has already died or a person who doesn‟t even exist

on records and still the records are not updated.

We are making an approach to prevent this outlaw with the help of Aadhar database and SMS verification techniques.

This involves maintaining sync between our proposed health card and the Aadhar card databases. With government‟s

support and permission, details of citizens such as age, life status (alive or dead) and income of family can be derived

from Aadhar database and mapped onto health card database. The work of secondary AWW, who visits each and every

house for health check up would be also to collect the life status information of the members of each and every family he

visits. It would be then updated to health centers, which then updates the Aadhar database. As a verification strategy, our

ICDS SMS server sends a verification query to the deceased person‟s family and the reply is sent to primary AWW‟s

workstation for tallying the data. Thus, prevents the misuse of authority by secondary AWW. Also, the same report is

sent to district health commissioner who does take care of primary AWW‟s management of health care facilities. In the

same way, whenever a medicine or vaccination is provided to families, the same SMS verification is used to track the

usage and requirement of medicines at each and every health centers.

F) Non-functional features

Security: At infrastructure level, securities requirements are met with controlled physical access, distributed storage,

default inbound firewall and facility to add filters to restrict inbound and outbound traffic.

Scalability: The system can be made scalable by using Amazon‟s services such as CloudWatch that provides real-time

visibility into resource utilization, operational performance, patterns for CPU utilization, disk I/O, and network traffic.

Amazon Scaling service will address the need for scaling up or down of the capacity based on the metrics provided by

CloudWatch.

Performance: The architecture‟s performance can be increased by using Elastic Load Balancing Service to balance load

between multiple machine instances within a zone, and across zones of a geographic region.

Disaster Recovery: Cloud site in a different availability zone is used for deploying a backup Machine Image.

G) Flow diagrams

Fig. 9 describes the flow/procedure followed by the AWW to deliver the services.


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Fig. 9 Flow diagram of AWW services

The Fig. 10 describes the flow/procedure followed by the user to request/utilize the ICDS services.

Fig. 10 Flow diagram of User‟s service initiation

H) ICDS DATABASE

The ICDS software database comprises of the following tables:

1) ‘Health card’ table:

The „Health Card‟ table denotes the basic information collected from the target users for the sake of registration under

ICDS service and then the card is issued after verification. It contains the required information required for a health care

system along with Aadhar card number entries of the target users or the head of family‟s Aadhar card number is also

sufficient for all the family members. It is used for address verification and also banking data is available, through which


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target users can be monitored. Depending on the family income, the target users get service bill compensation which

even includes free service for lower income groups.

2) ‘Health card authentication’ table:

Whenever the health card is used, it would be necessary for the users to authenticate and verify the services received

from AWW. So passwords are provided to all the target users and the same is maintained by „Health card authentication‟

table, to which restricted access is provided. It is to be noted that AWWs won‟t be having access to this database.

3) ‘Services’ table:

The services table comprises of all the services which the target users have used, their health card id , name and the

AWW who initiated it .The start and end date of the service is also indicated and „Status‟ of the service indicates whether

the service is opened , delayed , closed , needs revisit , needs to be transferred to hospital.

4) ‘SMS service’ table:

The target user can request for health care service through SMS/ mobile application, which are then stored in the central

database and the server processes the requests accordingly and provides notification to respective AWWs/hospitals. It

can also be used to request telemedicine van / hospital ambulance service.

5) ‘AWW center’ table:

The AWW and AWW centre details along with their contact number are listed in AWW_Centre table.

6) ‘Hospital’ table:

All the hospitals which support ICDS are listed in „hospital‟ table.

7) ‘Hospital services’ table:

The services delivered by hospitals to target users are listed in the „hospital_services‟ table.

8) ‘AWW’ table:

The „AWW‟ table gives the profile information of a AWW, describes his type (Primary AWW [Prefix - P] or Secondary

AWW). Secondary AWW is divided into preschool service AWW [prefix - SP] and nutrition service AWW [Prefix - SN].

The field „Managed_By‟ denoted the person who is managing the AWW_ID. For secondary AWW, Primary AWW will

be the manager and for primary AWW, District health Commissioner will be the manager.

9) ‘Training’ table:

Primary AWWs are trained about how to use the medical equipments, pre-school and nutrition based education by

District health commission. The primary AWW in turn train the secondary AWW. The table „Trainings‟ provide various

AWW training related information.

10) ‘GIS’ table:

The table „GIS‟ is used to denote the points(addresses) on the map which helps the AWW to know which all place he

visited , which all place needs re-visit and which all places need to be visited. Also by using algorithms such as

„Travelling Salesman‟ at GIS servers, the primary AWW are benefitted to plan his journey. Primary AWW and district

health commissioner do monitor the same.

11) ‘Funds’ table:

The table „Funds‟ is used to track the funds granted by the government to various Anganwadi centers and hospitals. Fund

type may include various objectives (such as handling malnutrition, pre-schooling and immunization) of the ICDS

program for which the funds are granted.

12) ‘Funds used’ table:

The table „Funds_used‟ is used by Anganwadi centers and hospitals to track the funds available, funds spent and helps in

estimation of required or surplus funds. Thus the „Funds‟ and „Funds_used‟ database provide a means by which misuse

of funds can be reduced or even prevented.

The tables necessary for our ICDS database are shown below:


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IV. CONCLUSIONS

Our proposed software architecture framework embraces a service-oriented architecture (SOA) approach. Service-

oriented-architecture is a philosophy of design described as “the software equivalent of Lego bricks,” where a toolset of

mix-and-match units (“services”), each performing a well-defined task, can reside on different machines (including

geographically separated ones), ready to be used when needed. The most widespread implementations of SOA involve

the use of Web services, where a given computational resource/service can be invoked by a remote machine via

messages composed in XML and sent over HTTP, so that they can operate across firewalls. Think of a Web service, in its

simplest form, as a subroutine that can be called over the Internet. Following are the potential benefits of our proposed

architecture:

Simpler software design and implementation, by decomposing complex problems into smaller, more

manageable ones.

Improved software reusability through enhanced reuse of existing IT resources.

Cost savings consequent to the above benefits.

The user interface, or frontend, of ICDS architecture is quite interesting. It would be implemented using modern web

development techniques, working well across browsers and on mobile devices. This gives you a very fast, low-latency

user experience that's very durable in the face of high-traffic loads. The architecture of ICDS architecture would be an

example of both the challenges of integration different software services working together and distributed systems-

independent systems that may or may not be available or meeting certain service-level agreements or standards.

Our architecture focuses on the problem of persistent malnutrition in India. It uses an improved communication structure

and relational database to solve the existing problems. Our architecture provides the effective services to address

malnutrition, reaches children below age lesser than 6 yrs and most poor population and is targeted to the areas where the

malnutrition is highest. Although it assumes that there is no constraint on funds being provided by government, economic


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growth alone is insufficient to bring about significant reductions in the prevalence of malnourishment among children.

Without a major shakeup in policy and an improvement in the effectiveness of its implementation, the attainment of the

healthy and young India looks extremely unlikely.

ACKNOWLEDGMENT

We are extremely grateful to those who have helped and supported us during the project. Our deepest thanks to our

advisor Prof. Jayprakash Lalchandani, IIITB for his continuous encouragement and suggestions throughout the course of

this work. It was our pleasure to work under his guidance where he explained many scenarios where the project can be

used.

REFERENCES

[1] Reinhold Haux, “Health information systems - past, present, future.”, Int J Med Inform,2006

[2] Stephen Chu and Branko Cesnik, “A three-tier clinical information systems design model”, International Journal of

Medical Informatics, 2000

[3] Antti Sarela, Niranjan Bidargaddi and Mohan Karunanithi , “A Software Architecture and Data Model for

Community-Based Healthcare Environments”, 2012

[4] Abdel Ejnioui1, Mathieu Morjaret and Carlos E. Otero , “Software Architecture and Prototype for supporting

Medical Prescription Adherence Using SMS Services”, 2012

[5] The Wikipedia website. [Online]. Available:

www.en.wikipedia.org/wiki/Integrated_Child_Development_Services_(India)

[6] The ICDS website. [Online]. Available: http://www.wcd.nic.in/icds.htm

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