WHO Antenatal Care Guideline Implementation Guide
0.3.0 - CI Build International flag

WHO Antenatal Care Guideline Implementation Guide, published by World Health Organization (WHO). This guide is not an authorized publication; it is the continuous build for version 0.3.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-anc/ and changes regularly. See the Directory of published versions

Measure: ANC.IND.06 Pregnant women who received counselling on danger signs (%) during at least one ANC contact

Official URL: http://smart.who.int/anc/Measure/ANCIND06 Version: 0.3.0
Draft as of 2025-06-24 Computable Name: ANCIND06

Pregnant women who received counselling on danger signs (%) during at least one ANC contact

Knowledge Artifact Metadata
Name (machine-readable) ANCIND06
Title (human-readable) ANC.IND.06 Pregnant women who received counselling on danger signs (%) during at least one ANC contact
Status Draft
Experimental false
Description

Pregnant women who received counselling on danger signs (%) during at least one ANC contact

Measure Steward World Health Organization (WHO)
Steward Contact Details https://www.who.int
Measure Metadata
Version Number 0.3.0
Measure Scoring Proportion
Measure Type Process
Improvement Notation Increased score indicates improvement
Measure Population Criteria (ID: group-1)
Initial Population ID: initial-population
Description: No description provided Logic Definition: Initial Population
Denominator ID: denominator
Description: No description provided Logic Definition: Denominator
Numerator ID: numerator
Description: No description provided Logic Definition: Numerator
Stratifier ID: by-age
Stratifier ID: by-education-level
Measure Logic
Primary Library ANC.IND.06 Pregnant women who received counselling on danger signs (%) during at least one ANC contact
Dependency Description: Library PatientData
Resource: ANC Data Elements
Canonical URL: http://smart.who.int/anc/Library/ANCDataElements
Dependency Description: Library Cx
Resource: ANC Concepts
Canonical URL: http://smart.who.int/anc/Library/ANCConcepts
Dependency Description: Library FHIRHelpers
Resource: http://smart.who.int/anc/Library/FHIRHelpers|4.0.1
Canonical URL: http://smart.who.int/anc/Library/FHIRHelpers|4.0.1
Dependency Description: Library BaseData
Resource: ANC Base Data Elements
Canonical URL: http://smart.who.int/anc/Library/ANCBaseDataElements
Dependency Description: Library BCx
Resource: ANC Base Concepts
Canonical URL: http://smart.who.int/anc/Library/ANCBaseConcepts
Dependency Description: Library Stratifiers
Resource: ANC Stratifiers
Canonical URL: http://smart.who.int/anc/Library/ANCStratifiers
Dependency Description: Library WC
Resource: WHO Common
Canonical URL: http://smart.who.int/anc/Library/WHOCommon
Dependency Description: Library FC
Resource: FHIRCommon
Canonical URL: http://smart.who.int/anc/Library/FHIRCommon
Dependency Description: Code system ISO-8601-Derived Periods
Resource: http://ohie.org/CodeSystem/iso-8601-derived-periods
Canonical URL: http://ohie.org/CodeSystem/iso-8601-derived-periods
Dependency Description: Value set Counselling conducted on seeking care when danger signs occur
Resource: Counselling conducted on seeking care when danger signs occur
Canonical URL: http://smart.who.int/anc/ValueSet/anc-b10-de133
Dependency Description: Value set Antenatal care case
Resource: Antenatal care case
Canonical URL: http://smart.who.int/anc/ValueSet/antenatal-care-case
Dependency Description: Value set Reason for closing ANC record
Resource: Reason for closing ANC record
Canonical URL: http://smart.who.int/anc/ValueSet/anc-end-1
Dependency Description: Value set Qualifying Reason for closing ANC record Choices
Resource: Qualifying Reason for closing ANC record Choices
Canonical URL: http://smart.who.int/anc/ValueSet/qualifying-reason-for-closing-anc-record-choices
Direct Reference Code Display: 10-14 years
Code: P10Y--P14Y
System: http://ohie.org/CodeSystem/iso-8601-derived-periods
Direct Reference Code Display: 15-19 years
Code: P15Y--P19Y
System: http://ohie.org/CodeSystem/iso-8601-derived-periods
Direct Reference Code Display: 20+ years
Code: P20Y--P9999Y
System: http://ohie.org/CodeSystem/iso-8601-derived-periods
Parameter Name: Measurement Period
Use: In
Min Cardinality: 0
Max Cardinality: 1
Type: Period
Parameter Name: Numerator
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Age Stratifier
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Coding
Parameter Name: Denominator
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Education Level Stratifier
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: CodeableConcept
Parameter Name: Initial Population
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Measure Logic Data Requirements
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, status, performed
Code Filter(s):
Path: code
ValueSet: Counselling conducted on seeking care when danger signs occur
Data Requirement Type: EpisodeOfCare
Profile(s): EpisodeOfCare
Must Support Elements: type
Code Filter(s):
Path: type
ValueSet: Antenatal care case
Data Requirement Type: Patient
Profile(s): Patient
Must Support Elements: url, value
Data Requirement Type: Observation
Profile(s): Observation
Must Support Elements: code, status, effective, value
Code Filter(s):
Path: code
ValueSet: Reason for closing ANC record
Measure Logic Definitions
Logic Definition Library Name: ANCDataElements
/*
  @dataElement: ANC.B10.DE133 Counselling conducted on seeking care when danger signs occur
  @activity: ANC.B.10.6 Risk reduction & general counselling
  @description: Counselling provided on when and how to seek care when danger signs are present
*/
define "Counselling conducted on seeking care when danger signs occur":
  [Procedure: Cx."Counselling conducted on seeking care when danger signs occur"] P
    where P.status in { 'preparation', 'in-progress', 'on-hold', 'completed' }
Logic Definition Library Name: ANCBaseDataElements
/*
define "Pregnant":
  "Pregnancy" is not null
    or "Pregnancy status" in BCx."Pregnancy status - pregnant"

define "Pregnancy status":
  FHIRHelpers.ToConcept(
    Last(
      [Observation: BCx."Pregnancy status"] O
        where O.status = 'final'
        sort by FHIRHelpers.ToDateTime(effective as FHIR.dateTime)
    ).value
  )
*/

define "Antenatal care case":
  ["EpisodeOfCare": type in BCx."Antenatal care case"]
Logic Definition Library Name: ANCBaseDataElements
/*
@description: Most recent antenatal care case
*/
define "Pregnancy":
  First(
    "Antenatal care case" E
		  sort by start of period descending
	)
Logic Definition Library Name: ANCIND06
/*
Numerator: Number of pregnant women who received counselling on danger signs
Numerator Computation: COUNT of all women who received counselling on danger signs
*/
define Numerator:
  exists (
    PatientData."Counselling conducted on seeking care when danger signs occur" P
      where P.performed during BaseData."Pregnancy".period
  )
Logic Definition Library Name: ANCStratifiers
/*
By Patient Age as of the start of the Measurement Period
Age (10-14, 15-19, 20+)
*/
define "By Age":
  case
    when AgeInYearsAt(start of "Measurement Period") in Interval[10, 14] then "P10Y--P14Y"
    when AgeInYearsAt(start of "Measurement Period") in Interval[15, 19] then "P15Y--P19Y"
    when AgeInYearsAt(start of "Measurement Period") >= 20 then "P20Y--P9999Y"
    else null
  end
Logic Definition Library Name: ANCIND06
/*
Disaggregation: Age (10-14, 15-19, 20+)
*/
define "Age Stratifier":
  Stratifiers."By Age"
Logic Definition Library Name: ANCDataElements
/*
  @dataElement: ANC.End.1 Reason for closing ANC record
  @activity: ANC.End End
  @description: Select the reason why you are closing the woman's ANC record
*/
define "Reason for closing ANC record":
  [Observation: Cx."Reason for closing ANC record"] O
    where O.status in { 'final', 'amended', 'corrected' }
      and Coalesce(WC.ModifierExtension(O, 'who-notDone').value, false) is false
Logic Definition Library Name: ANCIND06
/*
Denominator: Total number of antenatal clients with a first contact
Denominator Computation: COUNT of all women whose records were closed (ANC close form) in the last reporting period due to any of the reasons below:
*live birth
*stillbirth
*miscarriage
*abortion
*woman died
*lost to follow-up
*moved away
*/
define Denominator:
  exists (
    PatientData."Reason for closing ANC record" R
      where FC.ToInterval(R.effective) during "Measurement Period"
        and R.value as FHIR.CodeableConcept in Stratifiers."Qualifying Reason for closing ANC record Choices"
  )
Logic Definition Library Name: ANCStratifiers
/*
By Patient Education Level (none, don't know, primary, secondary, higher)
*/
define "By Education Level":
  Patient.extension E
    where E.url = 'http://smart.who.int/anc/StructureDefinition/educationlevel'
    return E.value as CodeableConcept
Logic Definition Library Name: ANCIND06
/*
Disaggregation: Education Level (none, don't know, primary, secondary, higher)
*/
define "Education Level Stratifier":
  Stratifiers."By Education Level"
Logic Definition Library Name: ANCIND06
/*
Initial population: Antenatal clients
*/
define "Initial Population":
  exists (BaseData."Antenatal care case")
Logic Definition Library Name: FHIRHelpers
define function ToString(value ProcedureStatus): value.value
Logic Definition Library Name: FHIRHelpers
define function ToDateTime(value dateTime): value.value
Logic Definition Library Name: FHIRHelpers
define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period."start" is null then
            Interval(period."start".value, period."end".value]
        else
            Interval[period."start".value, period."end".value]
Logic Definition Library Name: FHIRHelpers
define function ToString(value ObservationStatus): value.value
Logic Definition Library Name: FHIRHelpers
define function ToBoolean(value boolean): value.value
Logic Definition Library Name: WHOCommon
/*
@description: Returns the single WHO core modifier extension (if present) on the given resource with the specified id.
@comment: This function uses singleton from to ensure that a run-time exception is thrown if there
is more than one extension on the given resource with the specified url.
*/
define function ModifierExtension(domainResource DomainResource, id String):
  singleton from ModifierExtensions(domainResource, id)
Logic Definition Library Name: WHOCommon
/*
@description: Returns any WHO core modifier extensions defined on the given resource with the specified id.
@comment: NOTE: Extensions are not the preferred approach, but are used as a way to access
content that is defined by extensions but not yet surfaced in the
CQL model info.
*/
define function ModifierExtensions(domainResource DomainResource, id String):
  domainResource.modifierExtension E
	  where E.url = ('http://fhir.org/guides/who/core/StructureDefinition/' + id)
		return E
Logic Definition Library Name: FHIRHelpers
define function ToString(value uri): value.value
Logic Definition Library Name: FHIRHelpers
define function ToConcept(concept FHIR.CodeableConcept):
    if concept is null then
        null
    else
        System.Concept {
            codes: concept.coding C return ToCode(C),
            display: concept.text.value
        }
Logic Definition Library Name: FHIRHelpers
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }
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