{ "resourceType" : "Questionnaire", "id" : "MpoxTallySheet", "meta" : { "profile" : ["http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire"] }, "text" : { "status" : "extensions", "div" : "

Generated Narrative: Questionnaire MpoxTallySheet

Profile: http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire

Structure\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
LinkIDTextCardinalityTypeFlagsDescription & Constraints\"doco\"
\".\"\".\" Mpox Tally Sheet questionnaire for disease surveillanceQuestionnairehttp://example.org/Questionnaire/MpoxTallySheet#0.1.0
\".\"\".\"\".\" 151479012557Reporting Site0..1group
\".\"\".\"\".\"\".\" 546255966914Hospital/Facility Location0..1display
\".\"\".\"\".\"\".\" user_roleUser Role0..1string\"icon\"/
\".\"\".\"\".\"\".\" user_facilityUser Facility0..1string\"icon\"/
\".\"\".\"\".\"\".\" user_wardUser Ward0..1string\"icon\"/
\".\"\".\"\".\"\".\" user_sub_countyUser Sub County0..1string\"icon\"/
\".\"\".\"\".\"\".\" user_countyUser County0..1string\"icon\"/
\".\"\".\"\".\"\".\" facility_levelnull0..1groupEnable When: user_role = VACCINATOR
\".\"\".\"\".\"\".\"\".\" 294367770999County1..1reference
\".\"\".\"\".\"\".\"\".\" 819946803642Sub County1..1reference
\".\"\".\"\".\"\".\"\".\" 819943434Ward1..1reference
\".\"\".\"\".\"\".\"\".\" 819946803677Health Facility1..1reference
\".\"\".\"\".\"\".\"\".\" 438862163919Type of health facility1..1choiceOptions: 3 options
\".\"\".\"\".\"\".\" sub_county_levelnull0..1groupEnable When: user_role = SUBCOUNTY_DISEASE_SURVEILLANCE_OFFICER
\".\"\".\"\".\"\".\"\".\" 294367770999_sub_countyCounty1..1reference
\".\"\".\"\".\"\".\"\".\" 819946803642_sub_countySub County1..1reference
\".\"\".\"\".\"\".\"\".\" 819943434_sub_countyWard1..1reference
\".\"\".\"\".\"\".\"\".\" 819946803677_sub_countyHealth Facility1..1reference
\".\"\".\"\".\"\".\"\".\" 438862163919_sub_countyType of health facility1..1choiceOptions: 3 options
\".\"\".\"\".\"\".\" county_levelnull0..1groupEnable When: user_role = COUNTY_DISEASE_SURVEILLANCE_OFFICER
\".\"\".\"\".\"\".\"\".\" 294367770999_countyCounty1..1reference
\".\"\".\"\".\"\".\"\".\" 819946803642_countySub County1..1reference
\".\"\".\"\".\"\".\"\".\" 819943434_countyWard1..1reference
\".\"\".\"\".\"\".\"\".\" 819946803677_countyHealth Facility1..1reference
\".\"\".\"\".\"\".\"\".\" 438862163919_countyType of health facility1..1choiceOptions: 3 options
\".\"\".\"\".\"\".\" national_levelnull0..1groupEnable When: user_role = ADMINISTRATOR
\".\"\".\"\".\"\".\"\".\" 294367770999_nationalCounty1..1reference
\".\"\".\"\".\"\".\"\".\" 819946803642_nationalSub County1..1reference
\".\"\".\"\".\"\".\"\".\" 819943434_nationalWard1..1reference
\".\"\".\"\".\"\".\"\".\" 819946803677_nationalHealth Facility1..1reference
\".\"\".\"\".\"\".\"\".\" 438862163919_nationalType of health facility1..1choiceOptions: 3 options
\".\"\".\"\".\"\".\" villageVillage1..1string
\".\"\".\"\".\"\".\" team_noTeam No1..1string
\".\"\".\"\".\"\".\" team_typeTeam type1..1choiceOptions: 3 options
\".\"\".\"\".\"\".\" campaign_dayCampaign Day1..1choiceOptions: 10 options
\".\"\".\"\".\"\".\" 728034137219Date1..1date
\".\"\".\"\".\"\".\" supervisor_nameSupervisor Name1..1string
\".\"\".\"\".\"\".\" supervisor_levelSupervisor Level1..1choiceOptions: 4 options
\".\"\".\"\".\" target_populationNumber Reached0..1group
\".\"\".\"\".\"\".\" hcw_18_39_reportedWere any healthcare workers aged 18–39 years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" hcw_18_39_maleNumber of male healthcare workers aged 18–39 years reported0..1integerEnable When: hcw_18_39_reported = yes (yes)
\".\"\".\"\".\"\".\" hcw_18_39_femaleNumber of female healthcare workers aged 18–39 years reported0..1integerEnable When: hcw_18_39_reported = yes (yes)
\".\"\".\"\".\"\".\" hcw_18_39_male_noNumber of male healthcare workers aged 18–39 years reported0..1integer\"icon\"/Enable When: hcw_18_39_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" hcw_18_39_female_noNumber of female healthcare workers aged 18–39 years reported0..1integer\"icon\"/Enable When: hcw_18_39_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" hcw_40_59_reportedWere any healthcare workers aged 40–59 years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" hcw_40_59_maleNumber of male healthcare workers aged 40–59 years reported0..1integerEnable When: hcw_40_59_reported = yes (yes)
\".\"\".\"\".\"\".\" hcw_40_59_femaleNumber of female healthcare workers aged 40–59 years reported0..1integerEnable When: hcw_40_59_reported = yes (yes)
\".\"\".\"\".\"\".\" hcw_40_59_male_noNumber of male healthcare workers aged 40–59 years reported0..1integer\"icon\"/Enable When: hcw_40_59_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" hcw_40_59_female_noNumber of female healthcare workers aged 40–59 years reported0..1integer\"icon\"/Enable When: hcw_40_59_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" hcw_60_plus_reportedWere any healthcare workers aged 60+ years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" hcw_60_plus_maleNumber of male healthcare workers aged 60+ years reported0..1integerEnable When: hcw_60_plus_reported = yes (yes)
\".\"\".\"\".\"\".\" hcw_60_plus_femaleNumber of female healthcare workers aged 60+ years reported0..1integerEnable When: hcw_60_plus_reported = yes (yes)
\".\"\".\"\".\"\".\" hcw_60_plus_male_noNumber of male healthcare workers aged 60+ years reported0..1integer\"icon\"/Enable When: hcw_60_plus_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" hcw_60_plus_female_noNumber of female healthcare workers aged 60+ years reported0..1integer\"icon\"/Enable When: hcw_60_plus_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" sw_under_18_reportedWere any sex workers aged under 18 years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" sw_under_18_maleNumber of male sex workers under 18 years reported0..1integerEnable When: sw_under_18_reported = yes (yes)
\".\"\".\"\".\"\".\" sw_under_18_femaleNumber of female sex workers aged under 18 years reported0..1integerEnable When: sw_under_18_reported = yes (yes)
\".\"\".\"\".\"\".\" sw_under_18_male_noNumber of male sex workers aged under 18 years reported0..1integer\"icon\"/Enable When: sw_under_18_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" sw_under_18_female_noNumber of female sex workers aged under 18 years reported0..1integer\"icon\"/Enable When: sw_under_18_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" sw_18_39_reportedWere any sex workers aged 18–39 years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" sw_18_39_maleNumber of male sex workers aged 18–39 years reported0..1integerEnable When: sw_18_39_reported = yes (yes)
\".\"\".\"\".\"\".\" sw_18_39_femaleNumber of female sex workers aged 18–39 years reported0..1integerEnable When: sw_18_39_reported = yes (yes)
\".\"\".\"\".\"\".\" sw_18_39_male_noNumber of male sex workers aged 18–39 years reported0..1integer\"icon\"/Enable When: sw_18_39_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" sw_18_39_female_noNumber of female sex workers aged 18–39 years reported0..1integer\"icon\"/Enable When: sw_18_39_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" sw_40_59_reportedWere any sex workers aged 40–59 years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" sw_40_59_maleNumber of male sex workers aged 40–59 years reported0..1integerEnable When: sw_40_59_reported = yes (yes)
\".\"\".\"\".\"\".\" sw_40_59_femaleNumber of female sex workers aged 40–59 years reported0..1integerEnable When: sw_40_59_reported = yes (yes)
\".\"\".\"\".\"\".\" sw_40_59_male_noNumber of male sex workers aged 40–59 years reported0..1integer\"icon\"/Enable When: sw_40_59_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" sw_40_59_female_noNumber of female sex workers aged 40–59 years reported0..1integer\"icon\"/Enable When: sw_40_59_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" sw_60_plus_reportedWere any sex workers aged 60+ years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" sw_60_plus_maleNumber of male sex workers aged 60+ years reported0..1integerEnable When: sw_60_plus_reported = yes (yes)
\".\"\".\"\".\"\".\" sw_60_plus_femaleNumber of female sex workers aged 60+ years reported0..1integerEnable When: sw_60_plus_reported = yes (yes)
\".\"\".\"\".\"\".\" sw_60_plus_male_noNumber of male sex workers aged 60+ years reported0..1integer\"icon\"/Enable When: sw_60_plus_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" sw_60_plus_female_noNumber of female sex workers aged 60+ years reported0..1integer\"icon\"/Enable When: sw_60_plus_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" td_18_39_reportedWere any truck drivers aged 18–39 years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" td_18_39_maleNumber of male truck drivers aged 18–39 years reported0..1integerEnable When: td_18_39_reported = yes (yes)
\".\"\".\"\".\"\".\" td_18_39_femaleNumber of female truck drivers aged 18–39 years reported0..1integerEnable When: td_18_39_reported = yes (yes)
\".\"\".\"\".\"\".\" td_18_39_male_noNumber of male truck drivers aged 18–39 years reported0..1integer\"icon\"/Enable When: td_18_39_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" td_18_39_female_noNumber of female truck drivers aged 18–39 years reported0..1integer\"icon\"/Enable When: td_18_39_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" td_40_59_reportedWere any truck drivers aged 40–59 years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" td_40_59_maleNumber of male truck drivers aged 40–59 years reported0..1integerEnable When: td_40_59_reported = yes (yes)
\".\"\".\"\".\"\".\" td_40_59_femaleNumber of female truck drivers aged 40–59 years reported0..1integerEnable When: td_40_59_reported = yes (yes)
\".\"\".\"\".\"\".\" td_40_59_male_noNumber of male truck drivers aged 40–59 years reported0..1integer\"icon\"/Enable When: td_40_59_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" td_40_59_female_noNumber of female truck drivers aged 40–59 years reported0..1integer\"icon\"/Enable When: td_40_59_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" td_60_plus_reportedWere any truck drivers aged 60+ years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" td_60_plus_maleNumber of male truck drivers aged 60+ years reported0..1integerEnable When: td_60_plus_reported = yes (yes)
\".\"\".\"\".\"\".\" td_60_plus_femaleNumber of female truck drivers aged 60+ years reported0..1integerEnable When: td_60_plus_reported = yes (yes)
\".\"\".\"\".\"\".\" td_60_plus_male_noNumber of male truck drivers aged 60+ years reported0..1integer\"icon\"/Enable When: td_60_plus_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" td_60_plus_female_noNumber of female truck drivers aged 60+ years reported0..1integer\"icon\"/Enable When: td_60_plus_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" others_18_39_reportedWere any others aged 18–39 years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" others_18_39_maleNumber of male others aged 18–39 years reported0..1integerEnable When: others_18_39_reported = yes (yes)
\".\"\".\"\".\"\".\" others_18_39_femaleNumber of female others aged 18–39 years reported0..1integerEnable When: others_18_39_reported = yes (yes)
\".\"\".\"\".\"\".\" others_18_39_male_noNumber of male others aged 18–39 years reported0..1integer\"icon\"/Enable When: others_18_39_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" others_18_39_female_noNumber of female others aged 18–39 years reported0..1integer\"icon\"/Enable When: others_18_39_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" others_40_59_reportedWere any others aged 40–59 years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" others_40_59_maleNumber of male others aged 40–59 years reported0..1integerEnable When: others_40_59_reported = yes (yes)
\".\"\".\"\".\"\".\" others_40_59_femaleNumber of female others aged 40–59 years reported0..1integerEnable When: others_40_59_reported = yes (yes)
\".\"\".\"\".\"\".\" others_40_59_male_noNumber of male others aged 40–59 years reported0..1integer\"icon\"/Enable When: others_40_59_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" others_40_59_female_noNumber of female others aged 40–59 years reported0..1integer\"icon\"/Enable When: others_40_59_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" others_60_plus_reportedWere any others aged 60+ years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" others_60_plus_maleNumber of male others aged 60+ years reported0..1integerEnable When: others_60_plus_reported = yes (yes)
\".\"\".\"\".\"\".\" others_60_plus_femaleNumber of female others aged 60+ years reported0..1integerEnable When: others_60_plus_reported = yes (yes)
\".\"\".\"\".\"\".\" others_60_plus_male_noNumber of male others aged 60+ years reported0..1integer\"icon\"/Enable When: others_60_plus_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" others_60_plus_female_noNumber of female others aged 60+ years reported0..1integer\"icon\"/Enable When: others_60_plus_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" contact_under_18_reportedWere any contacts aged under 18 years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" contact_under_18_maleNumber of male contacts aged under 18 years reported0..1integerEnable When: contact_under_18_reported = yes (yes)
\".\"\".\"\".\"\".\" contact_under_18_femaleNumber of female contacts aged under 18 years reported0..1integerEnable When: contact_under_18_reported = yes (yes)
\".\"\".\"\".\"\".\" contact_under_18_male_noNumber of male contacts aged under 18 years reported0..1integer\"icon\"/Enable When: contact_under_18_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" contact_under_18_female_noNumber of female contacts aged under 18 years reported0..1integer\"icon\"/Enable When: contact_under_18_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" contact_18_39_reportedWere any contacts aged 18–39 years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" contact_18_39_maleNumber of male contacts aged 18–39 years reported0..1integerEnable When: contact_18_39_reported = yes (yes)
\".\"\".\"\".\"\".\" contact_18_39_femaleNumber of female contacts aged 18–39 years reported0..1integerEnable When: contact_18_39_reported = yes (yes)
\".\"\".\"\".\"\".\" contact_18_39_male_noNumber of male contacts aged 18–39 years reported0..1integer\"icon\"/Enable When: contact_18_39_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" contact_18_39_female_noNumber of female contacts aged 18–39 years reported0..1integer\"icon\"/Enable When: contact_18_39_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" contact_40_59_reportedWere any contacts aged 40–59 years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" contact_40_59_maleNumber of male contacts aged 40–59 years reported0..1integerEnable When: contact_40_59_reported = yes (yes)
\".\"\".\"\".\"\".\" contact_40_59_femaleNumber of female contacts aged 40–59 years reported0..1integerEnable When: contact_40_59_reported = yes (yes)
\".\"\".\"\".\"\".\" contact_40_59_male_noNumber of male contacts aged 40–59 years reported0..1integer\"icon\"/Enable When: contact_40_59_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" contact_40_59_female_noNumber of female contacts aged 40–59 years reported0..1integer\"icon\"/Enable When: contact_40_59_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" contact_60_plus_reportedWere any contacts aged 60+ years reported?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" contact_60_plus_maleNumber of male contacts aged 60+ years reported0..1integerEnable When: contact_60_plus_reported = yes (yes)
\".\"\".\"\".\"\".\" contact_60_plus_femaleNumber of female contacts aged 60+ years reported0..1integerEnable When: contact_60_plus_reported = yes (yes)
\".\"\".\"\".\"\".\" contact_60_plus_male_noNumber of male contacts aged 60+ years reported0..1integer\"icon\"/Enable When: contact_60_plus_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\"\".\" contact_60_plus_female_noNumber of female contacts aged 60+ years reported0..1integer\"icon\"/Enable When: contact_60_plus_reported = no (no)
Initial Value: integer = 0
\".\"\".\"\".\" utilization_aefi_mpox_surveilanceVaccine Utilization, AEFI and Mpox Surveillance0..1group
\".\"\".\"\".\"\".\" vaccine_receivedNumber of doses of vaccine received1..1integer
\".\"\".\"\".\"\".\" vaccine_usedNumber of vaccine doses used1..1integer
\".\"\".\"\".\"\".\" vaccine_remainingNumber of vaccine doses remaining1..1integer
\".\"\".\"\".\"\".\" aefiAEFI0..1display
\".\"\".\"\".\"\".\" aefi_yes_noReported AEFI?1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" aefi_countNumber of vaccinee with reported AEFI1..1integerEnable When: aefi_yes_no = yes (yes)
\".\"\".\"\".\"\".\" surveilanceSurveilance0..1display
\".\"\".\"\".\"\".\" mpox_suspected_case_countNo. of Mpox Suspected Case detected1..1integer
\".\"\".\"\".\"\".\" rumour_trackingRumour Tracking0..1display
\".\"\".\"\".\"\".\" rumour_reportedWere any rumours reported1..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" rumour_detailsWhat was the rumour about1..1stringEnable When: rumour_reported = Yes (yes)
\".\"\".\"\".\"\".\" rumour_escalatedWere they escalated1..1choice\"icon\"/\"icon\"/Enable When: rumour_reported = Yes (yes)
Options: 2 options

\"doco\" Documentation for this format

Options Sets

Answer options for 438862163919

Answer options for 438862163919_sub_county

Answer options for 438862163919_county

Answer options for 438862163919_national

Answer options for team_type

Answer options for campaign_day

Answer options for supervisor_level

Answer options for hcw_18_39_reported

Answer options for hcw_40_59_reported

Answer options for hcw_60_plus_reported

Answer options for sw_under_18_reported

Answer options for sw_18_39_reported

Answer options for sw_40_59_reported

Answer options for sw_60_plus_reported

Answer options for td_18_39_reported

Answer options for td_40_59_reported

Answer options for td_60_plus_reported

Answer options for others_18_39_reported

Answer options for others_40_59_reported

Answer options for others_60_plus_reported

Answer options for contact_under_18_reported

Answer options for contact_18_39_reported

Answer options for contact_40_59_reported

Answer options for contact_60_plus_reported

Answer options for aefi_yes_no

Answer options for rumour_reported

Answer options for rumour_escalated

" }, "extension" : [{ "extension" : [{ "url" : "name", "valueCoding" : { "system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext", "code" : "patient" } }, { "url" : "type", "valueCode" : "Patient" }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext" }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "countyName", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='294367770999').answer.value.reference" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "patientCountyName", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='a4-county').answer.value.reference" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "patientSubCountyName", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='a3-sub-county').answer.value.reference" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "selectedSubCountyName", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='819946803642').answer.value.reference" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "selectedWardName", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='819943434').answer.value.reference" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "selectedFacilityName", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='819943434').answer.value.reference" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "assignedCounty", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='user_county').answer.value" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "assignedRole", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='user_role').answer.value" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "assignedSubCounty", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='user_sub_county').answer.value" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "assignedWard", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='user_ward').answer.value" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "assignedFacility", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='user_facility').answer.value" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "selectedCountyNameCounty", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='294367770999_county').answer.value.reference" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "selectedSubCountyNameCounty", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='819946803642_county').answer.value.reference" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "selectedWardNameCounty", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='819943434_county').answer.value.reference" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "selectedCountyNameNational", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='294367770999_national').answer.value.reference" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "selectedSubCountyNameNational", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='819946803642_national').answer.value.reference" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "selectedWardNameNational", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='819943434_national').answer.value.reference" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "selectedCountyNameSubCounty", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='294367770999_sub_county').answer.value.reference" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "selectedSubCountyNameSubCounty", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='819946803642_sub_county').answer.value.reference" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "selectedWardNameSubCounty", "language" : "text/fhirpath", "expression" : "%resource.descendants().where(linkId='819943434_sub_county').answer.value.reference" } }, { "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-entryMode", "valueCode" : "prior-edit" }], "url" : "http://example.org/Questionnaire/MpoxTallySheet", "version" : "0.1.0", "title" : "Mpox Tally Sheet", "status" : "active", "date" : "2026-04-04T09:09:24+00:00", "publisher" : "Kenya National Public Health Institute", "contact" : [{ "name" : "Kenya National Public Health Institute", "telecom" : [{ "system" : "url", "value" : "https://www.nphi.go.ke/" }] }, { "name" : "Kenya National Public Health Institute", "telecom" : [{ "system" : "url", "value" : "https://www.nphi.go.ke/", "use" : "work" }] }], "description" : "Mpox Tally Sheet questionnaire for disease surveillance", "jurisdiction" : [{ "coding" : [{ "system" : "urn:iso:std:iso:3166", "code" : "KE", "display" : "Kenya" }] }], "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "page", "display" : "Page" }] } }], "linkId" : "151479012557", "text" : "Reporting Site", "type" : "group", "item" : [{ "linkId" : "546255966914", "text" : "Hospital/Facility Location", "type" : "display" }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean" : true }], "linkId" : "user_role", "text" : "User Role", "type" : "string" }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean" : true }], "linkId" : "user_facility", "text" : "User Facility", "type" : "string" }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean" : true }], "linkId" : "user_ward", "text" : "User Ward", "type" : "string" }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean" : true }], "linkId" : "user_sub_county", "text" : "User Sub County", "type" : "string" }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean" : true }], "linkId" : "user_county", "text" : "User County", "type" : "string" }, { "linkId" : "facility_level", "type" : "group", "enableWhen" : [{ "question" : "user_role", "operator" : "=", "answerString" : "VACCINATOR" }], "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?_id={{%assignedCounty}}&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "294367770999", "text" : "County", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?_id={{%assignedSubCounty}}&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "819946803642", "text" : "Sub County", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?_id={{%assignedWard}}&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "819943434", "text" : "Ward", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?_id={{%assignedFacility}}&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "819946803677", "text" : "Health Facility", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "drop-down", "display" : "Drop down" }] } }], "linkId" : "438862163919", "text" : "Type of health facility", "type" : "choice", "required" : true, "answerOption" : [{ "valueCoding" : { "code" : "Private", "display" : "Private" } }, { "valueCoding" : { "code" : "Public", "display" : "Public" } }, { "valueCoding" : { "code" : "Faith Based", "display" : "Faith Based" } }] }] }, { "linkId" : "sub_county_level", "type" : "group", "enableWhen" : [{ "question" : "user_role", "operator" : "=", "answerString" : "SUBCOUNTY_DISEASE_SURVEILLANCE_OFFICER" }], "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?_id={{%assignedCounty}}&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "294367770999_sub_county", "text" : "County", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?_id={{%assignedSubCounty}}&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "819946803642_sub_county", "text" : "Sub County", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?partof={{%selectedSubCountyNameSubCounty}}&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "819943434_sub_county", "text" : "Ward", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?partof={{%selectedWardNameSubCounty}}&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "819946803677_sub_county", "text" : "Health Facility", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "drop-down", "display" : "Drop down" }] } }], "linkId" : "438862163919_sub_county", "text" : "Type of health facility", "type" : "choice", "required" : true, "answerOption" : [{ "valueCoding" : { "code" : "Private", "display" : "Private" } }, { "valueCoding" : { "code" : "Public", "display" : "Public" } }, { "valueCoding" : { "code" : "Faith Based", "display" : "Faith Based" } }] }] }, { "linkId" : "county_level", "type" : "group", "enableWhen" : [{ "question" : "user_role", "operator" : "=", "answerString" : "COUNTY_DISEASE_SURVEILLANCE_OFFICER" }], "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?_id={{%assignedCounty}}&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "294367770999_county", "text" : "County", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?partof={{%selectedCountyNameCounty}}&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "819946803642_county", "text" : "Sub County", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?partof={{%selectedSubCountyNameCounty}}&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "819943434_county", "text" : "Ward", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?partof={{%selectedWardNameCounty}}&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "819946803677_county", "text" : "Health Facility", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "drop-down", "display" : "Drop down" }] } }], "linkId" : "438862163919_county", "text" : "Type of health facility", "type" : "choice", "required" : true, "answerOption" : [{ "valueCoding" : { "code" : "Private", "display" : "Private" } }, { "valueCoding" : { "code" : "Public", "display" : "Public" } }, { "valueCoding" : { "code" : "Faith Based", "display" : "Faith Based" } }] }] }, { "linkId" : "national_level", "type" : "group", "enableWhen" : [{ "question" : "user_role", "operator" : "=", "answerString" : "ADMINISTRATOR" }], "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?partof=Location/0&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "294367770999_national", "text" : "County", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?partof={{%selectedCountyNameNational}}&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "819946803642_national", "text" : "Sub County", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?partof={{%selectedSubCountyNameNational}}&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "819943434_national", "text" : "Ward", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression", "valueExpression" : { "language" : "application/x-fhir-query", "expression" : "Location?partof={{%selectedWardNameNational}}&_sort=name" } }, { "extension" : [{ "url" : "path", "valueString" : "name" }, { "url" : "forDisplay", "valueBoolean" : true }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn" }], "linkId" : "819946803677_national", "text" : "Health Facility", "type" : "reference", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "drop-down", "display" : "Drop down" }] } }], "linkId" : "438862163919_national", "text" : "Type of health facility", "type" : "choice", "required" : true, "answerOption" : [{ "valueCoding" : { "code" : "Private", "display" : "Private" } }, { "valueCoding" : { "code" : "Public", "display" : "Public" } }, { "valueCoding" : { "code" : "Faith Based", "display" : "Faith Based" } }] }] }, { "linkId" : "village", "text" : "Village", "type" : "string", "required" : true }, { "linkId" : "team_no", "text" : "Team No", "type" : "string", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "drop-down", "display" : "Drop down" }] } }], "linkId" : "team_type", "text" : "Team type", "type" : "choice", "required" : true, "answerOption" : [{ "valueCoding" : { "code" : "static", "display" : "Static" } }, { "valueCoding" : { "code" : "temporary_fixed", "display" : "Temporary Fixed" } }, { "valueCoding" : { "code" : "mobile_sites", "display" : "Mobile sites" } }] }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "drop-down", "display" : "Drop down" }] } }], "linkId" : "campaign_day", "text" : "Campaign Day", "type" : "choice", "required" : true, "answerOption" : [{ "valueCoding" : { "code" : "1", "display" : "Day 1" } }, { "valueCoding" : { "code" : "2", "display" : "Day 2" } }, { "valueCoding" : { "code" : "3", "display" : "Day 3" } }, { "valueCoding" : { "code" : "4", "display" : "Day 4" } }, { "valueCoding" : { "code" : "5", "display" : "Day 5" } }, { "valueCoding" : { "code" : "6", "display" : "Day 6" } }, { "valueCoding" : { "code" : "7", "display" : "Day 7" } }, { "valueCoding" : { "code" : "8", "display" : "Day 8" } }, { "valueCoding" : { "code" : "9", "display" : "Day 9" } }, { "valueCoding" : { "code" : "10", "display" : "Day 10" } }] }, { "extension" : [{ "url" : "http://ehelse.no/fhir/StructureDefinition/validationtext", "valueString" : "Cannot be a date in the future" }, { "url" : "http://hl7.org/fhir/StructureDefinition/entryFormat", "valueString" : "dd-mm-yyyy" }, { "url" : "http://hl7.org/fhir/StructureDefinition/maxValue", "_valueDate" : { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue", "valueExpression" : { "language" : "text/fhirpath", "expression" : "today()" } }] } }], "linkId" : "728034137219", "text" : "Date", "type" : "date", "required" : true }, { "linkId" : "supervisor_name", "text" : "Supervisor Name", "type" : "string", "required" : true }, { "extension" : [{ "url" : 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"http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation", "valueCode" : "horizontal" }], "linkId" : "contact_18_39_reported", "text" : "Were any contacts aged 18–39 years reported?", "type" : "choice", "required" : true, "answerOption" : [{ "valueCoding" : { "code" : "yes", "display" : "Yes" } }, { "valueCoding" : { "code" : "no", "display" : "No" } }] }, { "linkId" : "contact_18_39_male", "text" : "Number of male contacts aged 18–39 years reported", "type" : "integer", "enableWhen" : [{ "question" : "contact_18_39_reported", "operator" : "=", "answerCoding" : { "code" : "yes" } }] }, { "linkId" : "contact_18_39_female", "text" : "Number of female contacts aged 18–39 years reported", "type" : "integer", "enableWhen" : [{ "question" : "contact_18_39_reported", "operator" : "=", "answerCoding" : { "code" : "yes" } }] }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean" : true }], "linkId" : "contact_18_39_male_no", 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"question" : "contact_40_59_reported", "operator" : "=", "answerCoding" : { "code" : "no" } }], "initial" : [{ "valueInteger" : 0 }] }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean" : true }], "linkId" : "contact_40_59_female_no", "text" : "Number of female contacts aged 40–59 years reported", "type" : "integer", "enableWhen" : [{ "question" : "contact_40_59_reported", "operator" : "=", "answerCoding" : { "code" : "no" } }], "initial" : [{ "valueInteger" : 0 }] }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "radio-button", "display" : "Radio Button" }] } }, { "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation", "valueCode" : "horizontal" }], "linkId" : "contact_60_plus_reported", "text" : "Were any contacts aged 60+ years reported?", "type" : "choice", "required" : true, "answerOption" : [{ "valueCoding" : { "code" : "yes", "display" : "Yes" } }, { "valueCoding" : { "code" : "no", "display" : "No" } }] }, { "linkId" : "contact_60_plus_male", "text" : "Number of male contacts aged 60+ years reported", "type" : "integer", "enableWhen" : [{ "question" : "contact_60_plus_reported", "operator" : "=", "answerCoding" : { "code" : "yes" } }] }, { "linkId" : "contact_60_plus_female", "text" : "Number of female contacts aged 60+ years reported", "type" : "integer", "enableWhen" : [{ "question" : "contact_60_plus_reported", "operator" : "=", "answerCoding" : { "code" : "yes" } }] }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean" : true }], "linkId" : "contact_60_plus_male_no", "text" : "Number of male contacts aged 60+ years reported", "type" : "integer", "enableWhen" : [{ "question" : "contact_60_plus_reported", "operator" : "=", "answerCoding" : { "code" : "no" } }], "initial" : [{ "valueInteger" : 0 }] }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean" : true }], "linkId" : "contact_60_plus_female_no", "text" : "Number of female contacts aged 60+ years reported", "type" : "integer", "enableWhen" : [{ "question" : "contact_60_plus_reported", "operator" : "=", "answerCoding" : { "code" : "no" } }], "initial" : [{ "valueInteger" : 0 }] }] }, { "linkId" : "utilization_aefi_mpox_surveilance", "text" : "Vaccine Utilization, AEFI and Mpox Surveillance", "type" : "group", "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/maxValue", "valueInteger" : 9999 }], "linkId" : "vaccine_received", "text" : "Number of doses of vaccine received", "type" : "integer", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/maxValue", "valueInteger" : 9999 }, { "extension" : [{ "url" : "key", "valueId" : "constraint-1" }, { "url" : "requirements", "valueString" : "vaccine_used <= vaccine_received" }, { "url" : "severity", "valueCode" : "error" }, { "url" : "expression", "valueString" : "%context.answer.value <= %resource.descendants().where(linkId='vaccine_received').answer.value" }, { "url" : "human", "valueString" : "Doses used cannot be more than the doses received" }, { "url" : "location", "valueString" : "1" }], "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-constraint" }], "linkId" : "vaccine_used", "text" : "Number of vaccine doses used", "type" : "integer", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/maxValue", "valueInteger" : 9999 }, { "extension" : [{ "url" : "key", "valueId" : "constraint-1" }, { "url" : "requirements", "valueString" : "vaccine_used <= vaccine_received" }, { "url" : "severity", "valueCode" : "error" }, { "url" : "expression", "valueString" : "%context.answer.value <= %resource.descendants().where(linkId='vaccine_received').answer.value" }, { "url" : "human", "valueString" : "Doses used cannot be more than the doses received" }, { "url" : "location", "valueString" : "1" }], "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-constraint" }], "linkId" : "vaccine_remaining", "text" : "Number of vaccine doses remaining", "type" : "integer", "required" : true }, { "linkId" : "aefi", "text" : "AEFI", "type" : "display" }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "radio-button", "display" : "Radio Button" }] } }, { "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation", "valueCode" : "horizontal" }], "linkId" : "aefi_yes_no", "text" : "Reported AEFI?", "type" : "choice", "required" : true, "answerOption" : [{ "valueCoding" : { "code" : "yes", "display" : "Yes" } }, { "valueCoding" : { "code" : "no", "display" : "No" } }] }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/maxValue", "valueInteger" : 9999 }, { "extension" : [{ "url" : "key", "valueId" : "constraint-1" }, { "url" : "requirements", "valueString" : "aefi_count <= vaccine_used" }, { "url" : "severity", "valueCode" : "error" }, { "url" : "expression", "valueString" : "%context.answer.value <= %resource.descendants().where(linkId='vaccine_used').answer.value" }, { "url" : "human", "valueString" : "AEFI count cannot be more than the doses used" }, { "url" : "location", "valueString" : "1" }], "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-constraint" }], "linkId" : "aefi_count", "text" : "Number of vaccinee with reported AEFI", "type" : "integer", "enableWhen" : [{ "question" : "aefi_yes_no", "operator" : "=", "answerCoding" : { "code" : "yes" } }], "required" : true }, { "linkId" : "surveilance", "text" : "Surveilance", "type" : "display" }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/maxValue", "valueInteger" : 9999 }], "linkId" : "mpox_suspected_case_count", "text" : "No. of Mpox Suspected Case detected", "type" : "integer", "required" : true }, { "linkId" : "rumour_tracking", "text" : "Rumour Tracking", "type" : "display" }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "radio-button", "display" : "Radio Button" }] } }, { "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation", "valueCode" : "horizontal" }], "linkId" : "rumour_reported", "text" : "Were any rumours reported", "type" : "choice", "required" : true, "answerOption" : [{ "valueCoding" : { "code" : "yes", "display" : "Yes" } }, { "valueCoding" : { "code" : "no", "display" : "No" } }] }, { "linkId" : "rumour_details", "text" : "What was the rumour about", "type" : "string", "enableWhen" : [{ "question" : "rumour_reported", "operator" : "=", "answerCoding" : { "code" : "yes", "display" : "Yes" } }], "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "radio-button", "display" : "Radio Button" }] } }, { "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation", "valueCode" : "horizontal" }], "linkId" : "rumour_escalated", "text" : "Were they escalated", "type" : "choice", "enableWhen" : [{ "question" : "rumour_reported", "operator" : "=", "answerCoding" : { "code" : "yes", "display" : "Yes" } }], "required" : true, "answerOption" : [{ "valueCoding" : { "code" : "yes", "display" : "Yes" } }, { "valueCoding" : { "code" : "no", "display" : "No" } }] }] }] }