UNIVERSITY OF DAR ES SALAAM

RESEARCH PROPOSAL FOR PARTIAL FULFILLMENT OF MASTERS OF SCIENCE IN COMPUTER SCIENCE BY COURSEWORK AND DISSERTATION

1.0 NAME OF CANDIDATE: Kiyao, Fadhili (Reg. No. 2009-06-00193) (BSc. in Computer Science, UDSM)

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NAME OF SUPERVISOR: Dr. G. Justo

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DEPARTMENT: Computer Science Unit

FACULTY:

School of Informatics and Communication Technology (SCIT)

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PROPOSED DEGREE: MSc. in Computer Science

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TITLE:

ICT as a tool to enhance voluntarily counseling and testing for HIV/AIDS in Tanzania: A case of designing online TAWG HIV/AIDS counseling system

6.0 6.1

Introduction General Introduction

The human immunodeficiency virus (HIV) infection, which can cause acquired immunodeficiency syndrome (AIDS), has shown a high degree of prevalence in populations all over the world. According to the World Health Organization (WHO) reports, it shows that about 33.4 Million people were living with HIV/ AIDS in the world where 22.4 Million were from Sub-Saharan Africa to December 2008 (WHO AIDS epidemic update, 2009).

Knowledge of HIV status has always had the potential for benefiting an individuals health and wellbeing and for helping to prevent the further transmission of HIV. Knowledge of HIV status has been especially beneficial when it has enabled people to access care, support and treatment, in the form of psychosocial support; home based care; nutritional support; palliative care; treatment for opportunistic infections, tuberculosis and sexually transmitted infections; and antiretroviral therapy (WHO, 2002).

Knowing HIV/ AIDS status is only possible if an individual undertakes HIV/ AIDS testing, which is initiated by voluntarily counseling which prepares the individual to be ready willingly to undergo the testing and know his or her status.

HIV testing has also been problematic in the context of clinical care. This is because, in many places, HIV testing has reportedly either not been conducted at all as part of clinical care or has been conducted without consent, confidentiality, counseling, the provision of results or any follow-up care to benefit health. Even in places where people with AIDS occupy more than 50% of hospital beds, almost none of these people have

been diagnosed as HIV positive or told that they have AIDS. Although this phenomenon may result from fear that these patients will face discrimination or be denied health insurance, etc., if they are diagnosed as having AIDS, it also appears to be a form of medical denial that ultimately does not serve the best interests of these people or their families or communities (WHO, 2002).

The aim of this study is to investigate the current procedures of voluntarily and counseling for HIV/AIDS, also to investigate how the existing information technology is utilized to support Counseling and testing for HIV/AIDS. From this investigation a new strategy will be suggested on the utilization of information technology to improve the access to information and the counseling and testing of HIV/AIDS. After suggesting the new strategies, an online HIV/AIDS counseling system for TAWG will be developed, implemented and tested in order to cover all gapes that face to face counseling is facing. 6.2 Statement of the Problem

Online counseling provides an alternative to traditional face-to-face counseling at a time when traditional methods are inaccessible, inconvenient, or not preferred. Online counseling may be a useful alternative for people, unable to make it to a counselors office, live in a remote area, have a disability, limited time constraints, or would like to get an idea of how counseling works before seeing a counselor face to face.

Knowledge of HIV infection is necessary to access many forms of HIV-related support, care and treatment. As drugs become more affordable and political commitment and financial resources in support of access rise, greater access to care and treatment, including antiretroviral therapy, is becoming much more of a real possibility. Programmes are in place to increase the access to antiretroviral drugs in general and in 3

particular, to prevent mother-to-child transmission. Further, where treatment, care and support have become more widely available; stigma and discrimination, which have always been disincentives to HIV testing, have reportedly decreased.

Given that the changing landscape of the HIV/AIDS epidemic has resulted in new opportunities as well as new imperatives to increase knowledge of HIV status, there is a need to explore approaches to delivering HIV testing and counseling services.

6.3 6.3.1

Objectives of the Research General objective

The objective of the study is to investigate the current procedures of voluntarily and counseling for HIV/AIDS, also to investigate how the existing information technology is utilized to support Counseling and testing for HIV/AIDS.

6.3.2

Specific Objectives To study the operations of the normal counseling services for HIV/ AIDS To propose ICT based techniques for counseling services for HIV/ AIDS To implement the proposed techniques by building a online virtual counseling services for HIV/ AIDS for Tanga AIDS Working Group (TAWG)

6.4

Research Questions

The following are some research questions that will be answered by this study: What are the existing problems facing face to face counseling system for HIV/AIDS What are the problems facing online counseling services

How can ICT be used to enhance/ facilitate counseling services for HIV/ AIDS

6.5

Significance of the study

This research will address the importance of using Information and Communication tools as one of the way to improve access to information relating to HIV/ AIDS. Hence encourage people to attend the newly designed voluntarily counseling and testing for HIV/ AID since most people are avoiding to visit counseling and test due to forbear of people to think that there are affected since these services will be available anywhere

6.6 6.6.1

Literature Review Information about TAWG

The Tanga AIDS Working Group (TAWG) is an innovative non-governmental organization in Tanzania dedicated to caring for people with AIDS and reducing the spread of HIV. The main Objectives of TAWG is: -(http://www.tawg.net/Services.php) To provide home-based care and support to people living with AIDS and their families. To collaborate with traditional practitioners. To prevent the spread of HIV / AIDS through community-based education Programmes. 6.6.2 To provide guidance and assistance to other organizations working on Aids AIDS Counseling services in Tanzania (Limitations faced)

Provisions of HIV/AIDS counseling services in Tanzania started in 1988. In 2001, ANGAZA Program received a grant from USAID to enhance counseling and testing services in the country. However, Tanzania indicator survey of 2003-2004 indicated that 15% of people aged 15 to 49 years tested HIV. A national HIV testing campaign 5

was realized as one of the approaches for scaling up counseling and testing services as entry to HIV prevention, care and support services. ANGAZA Program supported launch of campaign in mid July 2007 and scaling up the campaign in the country.

The number of VCT sites has increased considerably during 2003 2007 implementation period. There were 1,027 VCT sites by the end of 2006, compared to 289 in 2003. This number includes sites in health facilities and stand alone sites. The geographic distribution of VCT sites is still inequitable, with an urban bias, although all districts have at least 4 sites. The number of clients counseled and tested has increased to 680,520 in 2006, up from about 140,000 in 2003. (NMSF, 2007)

Despite this considerable roll-out of service availability, the uptake of VCT in the country is still quite low. According to the Tanzania HIV/AIDS Indicators Survey (THIS) 2003/04, only about 15% of men and women are reported to have ever undertaken an HIV test. Women and men living in urban areas are two to three times more likely to have been tested than those in rural areas. One of the reasons for the low uptake is related to limited access to VCT services, particularly in the rural areas. Low public awareness about the benefits of knowing ones HIV status, insufficient human resources with skills in counseling and fear of stigma are also barriers to increased VCT utilization and the lack of care and support after HIV testing. The recent National voluntary HIV testing campaign aims at increasing the number of Tanzanian who know their HIV status and thus to take action to protect themselves and others

6.6.3

Computer Technology as a tool to improve Social Services

It is a good time to consider the power of current technological advances. Increasingly, communication and information technologies have become part of our everyday lives.

The use of computers is increasing day by day, because they are used in many fields to make our lives easier (Bayhan, Olgun, & Yelland, 2002). Computers can present crucial information and offer effective tutorial (An instructional book or program that takes the user through a prescribed sequence of steps in order to learn a product) instruction (Cammarata, 2006). Computers also connect us with other people, store vast amounts of data, and provide us with access and entertainment (Yelland, 2002).

6.6.4

Computer Technology in Education and Learning

Computer technology has important transformative effects on society (Logan, 1995). It provides concrete experiences, helps children control the learning experience (Papert, 1998), and supports children's development in all domains, as they use computers to investigate questions, solve problems, explore, and manipulate objects on a screen (Dodge, Colker, & Heroman, 2003). For example, children can use computers to investigate questions by using a program that teaches number concepts. Such a program might allow children to create "monsters," for example, by adding the right number of body parts. Also, children can explore with computers, using software programs that label vocabulary with pictures, written words, and spoken words. Such software programs often verbally identify an object when the child clicks on it. Some software programs allow children to match pictures of images to their beginning letters (Dodge et al., 2003).

Approaches to the use of ICT in education are presented within the context of education for a multidisciplinary human services workforce. A range of approaches are considered predominantly using a blended approach of ICT and face to face delivery. These include creating and sustaining community in a virtual environment to develop inter-professional skills. A focus of skill development is on reflective practices using

online role-plays and group work principles and processes in virtual situated learning environments. Issues for professional practice cultures in the online environment are considered within a global context (Martin, Jennifer & Hawkins, and Linette). 6.6.5 Computer Technology in Health

Information and communication technologies have changed the face of the world we live in. ICT enables people to communicate with family, friends and colleagues around the world instantaneously, gain access to global libraries, information resources, and numerous other opportunities. ICT may also bring an improvement in health care delivery systems. So, we may define Information and Communication Technology as one of the driving forces of globalization ICT encompasses the broad spectrum of communication technologies from radio, film, television, press, and telephone along with more participatory forms such as theatre, video or storytelling. It also focuses on the electronic end of the spectrum such as e-mail, the Internet, mobile phones and digital video. The science and practice of health or medical informatics changed radically in the late 1970s and early 1980s when computer use began to become increasingly common in healthcare environments (Shortliffe & Blois 2006). Since then, improvements in the speed and processing power of computers, computer networks, and the Internet has led to increased accessibility and availability of information for healthcare professionals to support their decision-making processes (Vimarlund et al 2008; Rose 2005; Winkelman & Leonard 2004; Chamorro 2001). According to Hassett (2002): A health information system (HIS) encompasses a wide array of applications and information systems that are linked or interfaced. A HIS supports the provision of care to patients and the business aspects of the healthcare organization by communicating information. It is now hard to imagine healthcare without information and communication technology (ICT) based applications for both the accumulation and interchange of clinical

information (Ammenwerth et al. 2004). This is in part because ICT-based applications have been recognized as enablers. This means that they are tools that offer solutions to the problem of the increasing accumulation of patient data (Timpka et al 2007; Andersen et al. 1994; Friedman 1996). Due to their central role in enabling ubiquitous access to information, ICTbased systems ensure a more efficient use of healthcare organizations scarce resources (Harrison et al. 2007; Rahimi et al 2008; Pardes et al. 2006).

6.6.6

Trust Management in online counseling services

For the Internet it is necessary to establish a foundation of trust among the participants, in order to be accepted as a viable platform, where the big companies can migrate their current desktop software applications. Trust is often mentioned in the context of ecommerce and has been developed over time through the formation of appropriate policies, procedures and practices to safeguard transactions and company assets (Furnell, M. S et al, 1999). The objective of security should be to manage risks by anticipating what is probably going to happen and limiting the risk exposures that could injure an organization's reputation. Perfect security is hard to achieve, infinitely expensive and often not a rational goal (Singhoi, A, 2000)

6.6.7

Mode of payments for social online Services

In the book at home

6.6.8

Computer Technology in HIV/ AIDS Fighting (Related works)

6.6.8.1 Online counseling platform for Mexican University

It integrates the database and communication tools needed to administer access and disseminate information between Course tutors and their students. On the student screen contains a number of features like a calendar where students can solicit and then program personal sessions with their tutors. Aims at providing students with the opportunity to reach their personal and professional growth and contribute to their ultimate success.

6.6.8.2 Grace Tree Counseling services Provides counseling services on Grief and loss issues, Survivors of family suicide, Depression & anxiety, marital and relationship issues, separation and divorce recovery, sexual abuse and incent and sexual addiction and abuse.

(http://www.gracetreecounceling.com)

6.6.8.3 Ask the internet therapist services Have therapists who are committed to working with people who are interested in improving their overall mental health, reducing anxiety, and enhancing relationship skills. Our online counselors are skilled in the areas of relationship counseling, love addiction, codependence, stress, assertiveness, dysfunctional family counseling, and chemical dependence counseling. We are confident that we can assist you in making the connection with your loved ones more rewarding and meaningful. (http://www.asktheinternettherapist.com/healthcare_medical_clinic_services.asp)

6.6.8.4 ICT based HIV/AIDS education ICT-based HIV/AIDS education and counselling services have been developed in various African countries, such as Uganda and Tanzania [Bloome 2001; Duveskoq 2008]. The existing e-learning approaches for HIV/AIDS education provide limited

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educational services to children with most solutions presenting static online content, carton-based stories and social networks using email as a means of communication [Bada and Suhonen 2008]. There is need to have a conceptual and pedagogical design of e-learning environment, which is aimed to provide a fresh perspective to the HIV/AIDS education and counselling services for Tanzanian. The design of TAWG online counselling service will provide the way forward to have an application that can cover all needed areas for Tanzanians. 6.6.9 Different Approaches to Systems Development

Systems Development Systems analysis is all about getting a detailed understanding of information relating to a proposed system collected previously (Avison and Shah, 1997). The phases of systems development are feasibility study, analysis, design, implementation, testing and maintenance .These phases of project development are the standard phases used more or less in all texts on systems analysis and software engineering. It is generally referred to as the Linear Life Cycle (Pressman, 1992).

Alternative methods of Systems Development: There have been many criticisms of the Linear Life Cycle. Thus, the Linear Life Cycle is looked on as way too simplified for the complexities of the real world. The following are some of the alternatives available to the simple Linear Life Cycle model. Prototyping Gerri (1999) define a Prototyping as the process of building a model of a system. In terms of an information system, prototypes are employed to help system designers build

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an information system that intuitive and easy to manipulate for end users. Prototyping is an iterative process that is part of the analysis phase of the cycle (Gerri, 1999). With prototyping the user feedback gained from developing a physical system that the users can touch and see facilitates an evaluative response that the analyst can employ to modify existing requirements as well as developing new ones (Gerri,1999). There are number of the advantages of the prototyping but some of them are reduced time of system development and decreases of cost in development process. Prototyping results in higher user satisfaction and expose developers to potential future system requirement (Gerri, 1999). The negative side of the prototyping includes the dangerous of the system being left in insufficient analysis. According to (Gerri, 1999) argues that now there is widespread use of prototypes of its advantage of inherently increase the quality and amount of communication between the developer/analyst and the end user. A Spiral Model This model aims to combine the best elements of the Linear Life Cycle and Prototyping but adding the new element of risk analysis (Pressman, 1992). Object Orientation (OO) Object orientated systems development requires the developer to think in terms of objects and object classes (Avison and Shah, 1997). This means that every attribute of a system is modeled just like it is in reality.

7.0 7.1

Materials and Methods The study area

The study areas for this case will be Tanga AIDS Working Group (TAWG).

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7.2

Methods

The following are techniques which will be used in the analyze of the current system of the flow and processing of information on HIV/ AIDS Counseling services Accurate information about HIV/ AIDS. 7.2.1 Primary source of data. Observation The observation will be made on how the face to face voluntarily counseling for HIV/AIDS is conducted how it can be modeled to cover distance counseling services. Interview The general questions will be asked from client that will help in collecting the user requirements. Most of prepared questions are open-end question in order to explore as much as information from the client. To analyze the data collected from open-end questions, qualitative analysis methods will be used where data will be examined and compared. The meaningfulness of the data will be determined by established goals and objectives of the research.

7.2.2

Using a secondary source of Data The review of the literature from previous research on how other countries process their online counseling services will be conducted. Other document for HIV/AIDS counseling services will be reviewed. 7.2.3 Software requirement analysis This will involve the following activities; develop the understanding of the application domain and Interact with the stakeholders in the system like Ministry 13

of Health and Social welfare, Tanga region Medical Officer, Counselors and the community as whole to know their requirements. 7.3 Materials On designing the system, MySQL DBMS will be used to implement the database schema, the PHP scripting language for creation of the user interface and link to database. Apache will be used as a web server. The reason for choosing the above tool is because they are open source. (i.e. free to use) 7.4 System Testing The unit test will be done first and after integration of different units, the whole system will be also tested. The system testing will be conducted to identify the correctness, completeness, security and quality of developed computer software. Testing will be performed on behalf of the stakeholders that are intended to reveal quality related information about the product with the respect to the context in which it is intended to operate.

7.5

Software architecture

The architecture of a software system refers to an abstract representation of that system. Researcher will produce one or more 'models' of what he see a system eventually look like, with ideas from the specification section either used or discarded. A document will be produced with a description of the system, but nothing is specific (Pressman, 2000). The figure below shows us the overview system architecture. It depicts all important parts of the system from the user (counselee) to the counselor.

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AIDS related Information

Social Network s

Online Multimedia Content

Online Counselling Services

HUMAN COMPUTER INTERFACE

HIV/AIDS Preventive educational Material Online Informational Materials

Social Networks Counsellor toCounsellor Communication Counselee to counsellor communication

Web-based Counselling Online Counsellor Online counselling Database

Digital Resources TECHNOLOGICAL REQUIREMENT

Interactive online content development using php, DHTML, Java Scripting Web 2.0 technologies for social networking Web based database for automated counselling. Use of communication tools chats, skype

TECHNOLOGIES FOR DIGITAL COUNSELING

Figure 1: Overview of the system Architecture

ENVIRONMENT DEVELOPMENT

8.0

Research Gap

Online counseling provides an alternative to traditional face-to-face counseling at a time when traditional methods are inaccessible, inconvenient, or not preferred. Online counseling may be a useful alternative for people, unable to make it to a counselors office, live in a remote area, have a disability, limited time constraints, or would like to get an idea of how counseling works before seeing a counselor face to face. This research is expected to cover the gap which is not covered by face to face counseling.

9.0

Research Contribution

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This is expected to contribute much not only in the field of computer but also to the community.

9.0.1

Contribution in the field of Computer Science

A new tool will be developed which will b used as a platform for other computer scientist to do other researches based on it.

9.0.2

Contribution to other fields

This research is expected to produce much contribution to other field like Health Science and counselling area as it will provide them with a new tool for their daily activities

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10.0

References:

Ammenwerth, E., Brender, J., Nykanen, P., Prokosch, H. U., Rigby, M., Talmon, J., 2004. Visions and strategies to improve evaluation of health information systems. Reflections and lessons based on the HISEVAL workshop in Innsbruck. International Journal of Medical Informatics, 73(6), p.479491. Andersen, J.G., Aydin, C.E., Jay, S.J., 1994. Evaluating Healthcare Information Systems: Methods and Applications. Thousand Oaks, CA: Sage publication. Avison, D., Shah, H. (1997). The Information Systems Development Life Cycle: A First Course in Information Systems, McGraw-Hill International, UK. Gerri A. (1999). Prototyping. Retrieved November 4, 2010 from http://www.umsl.edu/~sauter/analysis/prototyping/intro.html Bada , J. K and Suhonen , J. (2008). Towards ICT-based Education and Counseling SupportSystem for HIV/AIDS Prevention in Uganda. In Proceedings of Technology for Innovation and Education in Developing Countries. 31st July 2nd August 2008, Kampala Uganda. Bayhan, P., Olgun, P., & Yelland, N. (2002). A study of pre-school teachers' thoughts about computer-assisted instruction. Contemporary Issues in Early Childhood, 3(2), 298-303 Blome , A. (2001). Schools Think about HIV/AID. A World Links online Collaborative Project TechKowgia, July/August 2001. Retrieved 20th October, 2010 from http://www. Techknowlogia.org Cammarata, L. (2006). Instructional computer programmes and the phonological deficits of dyslexic children. Unpublished master's dissertation , Fairleigh Dickinson University, Rutherford, NJ. Dodge, D., Colker, L., & Heroman, C. (2003). The creative curriculum for preschool. Washington, DC: Teaching Strategies. 17

Duveskog , M. (2008). Website of Sura ya UKIMWI Environment. Retrieved November 3 , 2010 from http://www. Surayaukimwi.com Furnell M. S. and Karweni T. Security implications of electronic commerce: a survey of con-sumers and businesses. Internet Research: Electronic Networking and Policy, (5):372{382,1999. Harrison, M.I., Koppel, R., Bar-Lev, S.H., 2007. Unintended Consequences of Information Technologies in Health Care An Interactive Sociotechnical Analysis. Journal of the American Medical Informatics Association, 14(5), p.542549. Hassett, M.M., 2002. Applications for health care information systems. In S.P. Englebardt and R. Nelson, ed. Health care informatics: an interdisciplinary approach. Missouri: Mosby. CH. 7. Increasing access to HIV testing and counseling: report of a WHO consultation, 19- 21 November 2002, Geneva Switzerland

http://data.unaids.org/pub/Report/2009/JC1700_Epi_Update_2009_en.pdf accessed 16th august 2010 Informatics: form foundations to applications to policy. Washington DC. 8-12 November 2008. Information Communication Technologies for Human Services Education and Delivery: Concepts and Cases IRMA International Conference. (2006). Online counseling platform for Mexican University. Emerging Trends and Challenges in IT management, 337 - 340 Logan, R. (1995). The fifth language: Learning a living in the computer age. Toronto, Canada: Stoddart.

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Papert, S. (1998). Technology in schools: To support the system or render it obsolete? Milken Exchange on education technology. Retrieved April 24, 2008, from www.mff.org/edtech/article.taf?_function=detail&Content_uid1=106 Pardes, H., Lehmann, H.P., Abbott, P.A., Roderer, N.K., Rothschild, A., Mandell, S.F., Ferrer, J.A., Miller, R.E., Ball, M.J., 2006. Aspects of Electronic Health Record Systems (Health Informatics). New York: Springer-Verlag Inc. Pressman, R.S. (1992). Software Engineering: A Practitioner's Approach (Third Edition), McGraw-Hill, inc., USA. Rahimi, B., Moberg, A., Timpka, T. and Vimarlund, V., 2008. Implementing an integrated computerized patient record system: Toward for an evidence-based information system implementation practice in healthcare. In AMIA (American Medical Informatics Association), AMIA Annual Symposium, Biomedical and Health Rose, A.F., Schnipper, J.L., Park, E.R., Poon, E.G., Li, Q., Middleton, B., 2005. Using qualitative studies to improve the usability of an EMR. Journal of Biomedical Informatics, 38(1), p.51-60. Shortliffe, E.H., and Blois, M.S., 2006. The Computer Meets Medicine and Biology: Emergence of a Discipline. New York: Springer. Singhoi, A. Goriska eregion a new vision that can be accomplished by educating citizens and improving e-security. Preceeding of the fifteenths Blend Electronic Commerce Conference, pages 629{635, 2000. TACAIDS et al. (2005). Tanzania HIV/AIDS Indicator Survey 2003-04. Dar es Salaam, Tanzania The United Republic of Tanzania, Prime Ministers Office, The second national multi sectoral strategic framework on HIV and AIDS (2008 2012) second edition Dar es Salaam October, 2007

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Timpka, T., Bng, M., Delbanco, T., Walker, J., 2007. Information infrastructure for inter-organizational mental health services: an actor network theory analysis of psychiatric rehabilitation. Journal of biomedical informatics, 2007. 40(4), p.42937. Vimarlund, V., Olve, N.G., Scandurra, I., Koch, S., 2008. Organizational effects of information and communication technology (ICT) in elderly homecare: a case study. Health Informatics Journal, 14(3), p.195-210. Winkelman, W.J., Leonard, K.J., 2004. Overcoming Structural Constraints to Patient Utilization of Electronic Medical Records: A Critical Review and Proposal for an Evaluation Framework. Journal of the American Medical Informatics Association, 11(2), p.151-161. Yelland, N. (2002). Playing with ideas and games in early mathematics. Contemporary Issues in Early Childhood, 3(2), 197-215.

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11.0 Other Relevant Information 11.1 Estimated Budget Item No 1 2 3 4 Items Data collection, Analysis Design and implementation Dissertation Report Writing Cost(Tshs) 1,700,000 500,000 800,000 300,000 3,300,000

Stationary Contingence Total Budget Costs Table 1: Estimated budget 11.2 Research Schedule 2010 Jul Au y Data collection Data Analysis System Design System Implementati on Report write up and submission Table 2: Research Schedule g 2011 Jan Fe b

Activity

Sep t

Oct Nov

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Ma r

Ap r

May

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Date .. Kiyao, Fadhili (200906-00193) SUPERVISOR COMMENTS: .. Signature:Date:

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