WHO Antenatal Care Guideline Implementation Guide
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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

: ANC.IND.10 Percentage of pregnant women with an ultrasound scan before 24 weeks - XML Representation

Draft as of 2025-06-24

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<Measure xmlns="http://hl7.org/fhir">
  <id value="ANCIND10"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
  <table class="narrative-table">
    <tbody>
<tr>

<th colspan="2" scope="row" class="row-header">Knowledge Artifact Metadata</th>

</tr>

<tr>

<th scope="row" class="row-header">Name (machine-readable)</th>

<td class="content-container">ANCIND10</td>
</tr>


<tr>

<th scope="row" class="row-header">Title (human-readable)</th>

<td class="content-container">ANC.IND.10 Percentage of pregnant women with an ultrasound scan before 24 weeks</td>
</tr>



<tr>

<th scope="row" class="row-header">Status</th>

<td class="content-container">Draft</td>
</tr>


<tr>

<th scope="row" class="row-header">Experimental</th>

<td class="content-container">false</td>
</tr>


<tr>

<th scope="row" class="row-header">Description</th>

<td class="content-container"><div><p>Percentage of pregnant women with an ultrasound scan before 24 weeks</p>
</div></td>
</tr>












<tr>

<th scope="row" class="row-header">Measure Steward</th>

<td class="content-container">World Health Organization (WHO)</td>
</tr>


<tr>

<th scope="row" class="row-header">Steward Contact Details</th>

<td class="content-container"><a href="https://www.who.int">https://www.who.int</a></td>
</tr>











<tr>

<th colspan="2" scope="row" class="row-header">Measure Metadata</th>

</tr>






<tr>

<th scope="row" class="row-header">Version Number</th>

<td class="content-container">0.3.0</td>
</tr>


<tr>

<th scope="row" class="row-header">Measure Scoring</th>

<td class="content-container"><span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-scoring proportion}">Proportion</span></td>
</tr>



<tr>

<th scope="row" class="row-header">Measure Type</th>

<td class="content-container"><span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-type process}">Process</span></td>
</tr>






<tr>

<th scope="row" class="row-header">Improvement Notation</th>

<td class="content-container"><span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-improvement-notation increase}">Increased score indicates improvement</span></td>
</tr>








  
    
    <tr>

<th colspan="2" scope="row" class="row-header">Measure Population Criteria (ID: group-1)</th>

</tr>
  
  
  
  
    <tr>
      
        
          
            
<th scope="row" class="row-header">Initial Population</th>

          
          
          
          
          
          
          
          
          
        
      
      <td class="content-container">
        
        <em>ID</em>: initial-population
        <br/>
        
        
          <em>Description</em>: No description provided
        
        
          
            
            <em>Logic Definition</em>: <a href="#ancind10-initial-population">Initial Population</a> 
          
        
      </td>
    </tr>
  

  
    <tr>
      
        
          
          
          
          
            
<th scope="row" class="row-header">Denominator</th>

          
          
          
          
          
          
        
      
      <td class="content-container">
        
        <em>ID</em>: denominator
        <br/>
        
        
          <em>Description</em>: No description provided
        
        
          
            
            <em>Logic Definition</em>: <a href="#ancind10-denominator">Denominator</a> 
          
        
      </td>
    </tr>
  

  
    <tr>
      
        
          
          
            
<th scope="row" class="row-header">Numerator</th>

          
          
          
          
          
          
          
          
        
      
      <td class="content-container">
        
        <em>ID</em>: numerator
        <br/>
        
        
          <em>Description</em>: No description provided
        
        
          
            
            <em>Logic Definition</em>: <a href="#ancind10-numerator">Numerator</a> 
          
        
      </td>
    </tr>
  

  
<tr>
  
<th scope="row" class="row-header">Stratifier</th>

  <td class="content-container">
    
      <em>ID</em>: by-age
      
    
    
    
  </td>
</tr>

<tr>
  
<th scope="row" class="row-header">Stratifier</th>

  <td class="content-container">
    
      <em>ID</em>: by-education-level
      
    
    
    
  </td>
</tr>

  













<tr>

<th colspan="2" scope="row" class="row-header">Measure Logic</th>

</tr>

<tr>

<th scope="row" class="row-header">Primary Library</th>

<td class="content-container"><a href="Library-ANCIND10.html">ANC.IND.10 Percentage of pregnant women with an ultrasound scan before 24 weeks</a></td>
</tr>




  
  

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Library PatientData
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="Library-ANCDataElements.html">ANC Data Elements</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://smart.who.int/anc/Library/ANCDataElements</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Library Cx
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="Library-ANCConcepts.html">ANC Concepts</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://smart.who.int/anc/Library/ANCConcepts</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Library FHIRHelpers
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://smart.who.int/anc/Library/FHIRHelpers|4.0.1</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://smart.who.int/anc/Library/FHIRHelpers|4.0.1</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Library FC
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="Library-FHIRCommon.html">FHIRCommon</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://smart.who.int/anc/Library/FHIRCommon</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Library BaseData
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="Library-ANCBaseDataElements.html">ANC Base Data Elements</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://smart.who.int/anc/Library/ANCBaseDataElements</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Library BCx
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="Library-ANCBaseConcepts.html">ANC Base Concepts</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://smart.who.int/anc/Library/ANCBaseConcepts</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Library Stratifiers
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="Library-ANCStratifiers.html">ANC Stratifiers</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://smart.who.int/anc/Library/ANCStratifiers</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Library WC
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="Library-WHOCommon.html">WHO Common</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://smart.who.int/anc/Library/WHOCommon</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Code system ISO-8601-Derived Periods
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://ohie.org/CodeSystem/iso-8601-derived-periods</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://ohie.org/CodeSystem/iso-8601-derived-periods</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Ultrasound scan conducted
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="ValueSet-anc-b9-de3.html">Ultrasound scan conducted</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://smart.who.int/anc/ValueSet/anc-b9-de3</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Antenatal care case
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="ValueSet-antenatal-care-case.html">Antenatal care case</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://smart.who.int/anc/ValueSet/antenatal-care-case</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Gestational age
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="ValueSet-anc-b6-de17.html">Gestational age</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://smart.who.int/anc/ValueSet/anc-b6-de17</tt>
    
  </td>
</tr>


  
  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: 10-14 years
        <br/>
      
      <em>Code</em>: P10Y--P14Y
      <br/>
      <em>System</em>: <tt>http://ohie.org/CodeSystem/iso-8601-derived-periods</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: 15-19 years
        <br/>
      
      <em>Code</em>: P15Y--P19Y
      <br/>
      <em>System</em>: <tt>http://ohie.org/CodeSystem/iso-8601-derived-periods</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: 20+ years
        <br/>
      
      <em>Code</em>: P20Y--P9999Y
      <br/>
      <em>System</em>: <tt>http://ohie.org/CodeSystem/iso-8601-derived-periods</tt>
    </td>
  </tr>

  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: Measurement Period
    <br/>
    <em>Use</em>: In
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: 1
    <br/>
    <em>Type</em>: Period
  </td>
</tr>
  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: Numerator
    <br/>
    <em>Use</em>: Out
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: 1
    <br/>
    <em>Type</em>: boolean
  </td>
</tr>
  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: Age Stratifier
    <br/>
    <em>Use</em>: Out
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: 1
    <br/>
    <em>Type</em>: Coding
  </td>
</tr>
  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: Denominator
    <br/>
    <em>Use</em>: Out
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: 1
    <br/>
    <em>Type</em>: boolean
  </td>
</tr>
  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: Education Level Stratifier
    <br/>
    <em>Use</em>: Out
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: *
    <br/>
    <em>Type</em>: CodeableConcept
  </td>
</tr>
  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: Initial Population
    <br/>
    <em>Use</em>: Out
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: 1
    <br/>
    <em>Type</em>: boolean
  </td>
</tr>
  
  
  <tr>
    <th colspan="2" scope="row" class="section-header"><a name="effective-data-requirements"> </a>Measure Logic Data Requirements</th>
  </tr>
  
  
<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Procedure
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, status, performed
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <a href="ValueSet-anc-b9-de3.html">Ultrasound scan conducted</a>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: EpisodeOfCare
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/episodeofcare.html">EpisodeOfCare</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: type</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <a href="ValueSet-antenatal-care-case.html">Antenatal care case</a>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Patient
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/patient.html">Patient</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: url, value
    <br/>
   
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Observation
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/observation.html">Observation</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, status, effective, value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <a href="ValueSet-anc-b6-de17.html">Gestational age</a>
    <br/> 
  
  
  
   
  </td>
</tr>

  
  <tr>

<th colspan="2" scope="row" class="row-header">Measure Logic Definitions</th>

</tr>
  
          
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="ancdataelements-ultrasound-scan-conducted"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> ANCDataElements</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
  @dataElement: ANC.B9.DE3 Ultrasound scan conducted
  @activity: ANC.B6. Collect woman's profile and history
  @description: Whether an ultrasound scan was conducted during a specific contact
*/
define &quot;Ultrasound scan conducted&quot;:
  [Procedure: Cx.&quot;Ultrasound scan conducted&quot;] P
    where P.status in { 'preparation', 'in-progress', 'on-hold', 'completed' }</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="ancbasedataelements-antenatal-care-case"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> ANCBaseDataElements</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
define &quot;Pregnant&quot;:
  &quot;Pregnancy&quot; is not null
    or &quot;Pregnancy status&quot; in BCx.&quot;Pregnancy status - pregnant&quot;

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

define &quot;Antenatal care case&quot;:
  [&quot;EpisodeOfCare&quot;: type in BCx.&quot;Antenatal care case&quot;]</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="ancbasedataelements-pregnancy"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> ANCBaseDataElements</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Most recent antenatal care case
*/
define &quot;Pregnancy&quot;:
  First(
    &quot;Antenatal care case&quot; E
		  sort by start of period descending
	)</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="ancind10-numerator"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> ANCIND10</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
Numerator: Number of pregnant women who received ultrasound scan before 24 weeks 
Numerator Computation: COUNT of all women who had an ultrasound scan done before 24 weeks gestational age 
*/
define Numerator:
  exists (
    PatientData.&quot;Ultrasound scan conducted&quot; P
      where FC.ToInterval(P.performed) during Interval[start of BaseData.&quot;Pregnancy&quot;.period, start of BaseData.&quot;Pregnancy&quot;.period + 24 weeks]
    )</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="ancstratifiers-by-age"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> ANCStratifiers</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
By Patient Age as of the start of the Measurement Period
Age (10-14, 15-19, 20+)
*/
define &quot;By Age&quot;:
  case
    when AgeInYearsAt(start of &quot;Measurement Period&quot;) in Interval[10, 14] then &quot;P10Y--P14Y&quot;
    when AgeInYearsAt(start of &quot;Measurement Period&quot;) in Interval[15, 19] then &quot;P15Y--P19Y&quot;
    when AgeInYearsAt(start of &quot;Measurement Period&quot;) &gt;= 20 then &quot;P20Y--P9999Y&quot;
    else null
  end</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="ancind10-age-stratifier"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> ANCIND10</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
Disaggregation: Age (10-14, 15-19, 20+)
*/
define &quot;Age Stratifier&quot;:
  Stratifiers.&quot;By Age&quot;</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="ancdataelements-gestational-age"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> ANCDataElements</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
  @dataElement: ANC.B6.DE17 Gestational age
  @activity: ANC.B6. Collect woman's profile and history
  @description: Gestational age in weeks and/or days depending on the source of gestational age
*/
define &quot;Gestational age&quot;:
  [Observation: Cx.&quot;Gestational age&quot;] O
    where O.status in { 'final', 'amended', 'corrected' }
      and Coalesce(WC.ModifierExtension(O, 'who-notDone').value, false) is false</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="ancind10-denominator"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> ANCIND10</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
Denominator: Total number of antenatal clients with gestational age equal to 24 weeks
Denominator Computation: COUNT of all pregnant women who reached 24 weeks gestational age in the past calendar month 
*/
define Denominator:
  exists (
    PatientData.&quot;Gestational age&quot; GA
      where FC.ToInterval(GA.effective) during &quot;Measurement Period&quot;
        and GA.value = 24 weeks
  )</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="ancstratifiers-by-education-level"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> ANCStratifiers</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
By Patient Education Level (none, don't know, primary, secondary, higher)
*/
define &quot;By Education Level&quot;:
  Patient.extension E
    where E.url = 'http://smart.who.int/anc/StructureDefinition/educationlevel'
    return E.value as CodeableConcept</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="ancind10-education-level-stratifier"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> ANCIND10</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
Disaggregation: Education Level (none, don't know, primary, secondary, higher)
*/
define &quot;Education Level Stratifier&quot;:
  Stratifiers.&quot;By Education Level&quot;</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="ancind10-initial-population"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> ANCIND10</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
Initial population: Antenatal clients
*/
define &quot;Initial Population&quot;:
  exists (BaseData.&quot;Antenatal care case&quot;)</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="fhirhelpers-tostring"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value ProcedureStatus): value.value</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="fhirhelpers-tointerval"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period.&quot;start&quot; is null then
            Interval(period.&quot;start&quot;.value, period.&quot;end&quot;.value]
        else
            Interval[period.&quot;start&quot;.value, period.&quot;end&quot;.value]</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="fhirhelpers-tostring"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value ObservationStatus): value.value</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="fhirhelpers-toboolean"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToBoolean(value boolean): value.value</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="whocommon-modifierextension"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> WHOCommon</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@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)</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="whocommon-modifierextensions"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> WHOCommon</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@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</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="fhirhelpers-tostring"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value uri): value.value</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="fhirhelpers-toquantity"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToQuantity(quantity FHIR.Quantity):
    case
        when quantity is null then null
        when quantity.value is null then null
        when quantity.comparator is not null then
            Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')
        when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'
              or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then
            System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }
        else
            Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' &amp; quantity.unit.value &amp; ' (' &amp; quantity.system.value &amp; '|' &amp; quantity.code.value &amp; ')')
    end</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="fhirhelpers-tocalendarunit"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToCalendarUnit(unit System.String):
    case unit
        when 'ms' then 'millisecond'
        when 's' then 'second'
        when 'min' then 'minute'
        when 'h' then 'hour'
        when 'd' then 'day'
        when 'wk' then 'week'
        when 'mo' then 'month'
        when 'a' then 'year'
        else unit
    end</code></pre>
  </td>

</tr>

  

<tr>
  <th colspan="2" scope="row" class="row-header">Generated using version 0.4.6 of the sample-content-ig Liquid templates</th>
</tr>
    </tbody>
  </table>
</div>
  </text>
  <contained>
    <Library>
      <id value="effective-data-requirements"/>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
        <valueCoding>
          <system
                  value="http://ohie.org/CodeSystem/iso-8601-derived-periods"/>
          <code value="P10Y--P14Y"/>
          <display value="10-14 years"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
        <valueCoding>
          <system
                  value="http://ohie.org/CodeSystem/iso-8601-derived-periods"/>
          <code value="P15Y--P19Y"/>
          <display value="15-19 years"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
        <valueCoding>
          <system
                  value="http://ohie.org/CodeSystem/iso-8601-derived-periods"/>
          <code value="P20Y--P9999Y"/>
          <display value="20+ years"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="ANCDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="Ultrasound scan conducted"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
  @dataElement: ANC.B9.DE3 Ultrasound scan conducted
  @activity: ANC.B6. Collect woman's profile and history
  @description: Whether an ultrasound scan was conducted during a specific contact
*/
define &quot;Ultrasound scan conducted&quot;:
  [Procedure: Cx.&quot;Ultrasound scan conducted&quot;] P
    where P.status in { 'preparation', 'in-progress', 'on-hold', 'completed' }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="0"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="ANCBaseDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="Antenatal care case"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
define &quot;Pregnant&quot;:
  &quot;Pregnancy&quot; is not null
    or &quot;Pregnancy status&quot; in BCx.&quot;Pregnancy status - pregnant&quot;

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

define &quot;Antenatal care case&quot;:
  [&quot;EpisodeOfCare&quot;: type in BCx.&quot;Antenatal care case&quot;]"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="1"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="ANCBaseDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="Pregnancy"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@description: Most recent antenatal care case
*/
define &quot;Pregnancy&quot;:
  First(
    &quot;Antenatal care case&quot; E
		  sort by start of period descending
	)"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="2"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="ANCIND10"/>
        </extension>
        <extension url="name">
          <valueString value="Numerator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
Numerator: Number of pregnant women who received ultrasound scan before 24 weeks 
Numerator Computation: COUNT of all women who had an ultrasound scan done before 24 weeks gestational age 
*/
define Numerator:
  exists (
    PatientData.&quot;Ultrasound scan conducted&quot; P
      where FC.ToInterval(P.performed) during Interval[start of BaseData.&quot;Pregnancy&quot;.period, start of BaseData.&quot;Pregnancy&quot;.period + 24 weeks]
    )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="3"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="ANCStratifiers"/>
        </extension>
        <extension url="name">
          <valueString value="By Age"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
By Patient Age as of the start of the Measurement Period
Age (10-14, 15-19, 20+)
*/
define &quot;By Age&quot;:
  case
    when AgeInYearsAt(start of &quot;Measurement Period&quot;) in Interval[10, 14] then &quot;P10Y--P14Y&quot;
    when AgeInYearsAt(start of &quot;Measurement Period&quot;) in Interval[15, 19] then &quot;P15Y--P19Y&quot;
    when AgeInYearsAt(start of &quot;Measurement Period&quot;) &gt;= 20 then &quot;P20Y--P9999Y&quot;
    else null
  end"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="4"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="ANCIND10"/>
        </extension>
        <extension url="name">
          <valueString value="Age Stratifier"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
Disaggregation: Age (10-14, 15-19, 20+)
*/
define &quot;Age Stratifier&quot;:
  Stratifiers.&quot;By Age&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="5"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="ANCDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="Gestational age"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
  @dataElement: ANC.B6.DE17 Gestational age
  @activity: ANC.B6. Collect woman's profile and history
  @description: Gestational age in weeks and/or days depending on the source of gestational age
*/
define &quot;Gestational age&quot;:
  [Observation: Cx.&quot;Gestational age&quot;] O
    where O.status in { 'final', 'amended', 'corrected' }
      and Coalesce(WC.ModifierExtension(O, 'who-notDone').value, false) is false"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="6"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="ANCIND10"/>
        </extension>
        <extension url="name">
          <valueString value="Denominator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
Denominator: Total number of antenatal clients with gestational age equal to 24 weeks
Denominator Computation: COUNT of all pregnant women who reached 24 weeks gestational age in the past calendar month 
*/
define Denominator:
  exists (
    PatientData.&quot;Gestational age&quot; GA
      where FC.ToInterval(GA.effective) during &quot;Measurement Period&quot;
        and GA.value = 24 weeks
  )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="7"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="ANCStratifiers"/>
        </extension>
        <extension url="name">
          <valueString value="By Education Level"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
By Patient Education Level (none, don't know, primary, secondary, higher)
*/
define &quot;By Education Level&quot;:
  Patient.extension E
    where E.url = 'http://smart.who.int/anc/StructureDefinition/educationlevel'
    return E.value as CodeableConcept"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="8"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="ANCIND10"/>
        </extension>
        <extension url="name">
          <valueString value="Education Level Stratifier"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
Disaggregation: Education Level (none, don't know, primary, secondary, higher)
*/
define &quot;Education Level Stratifier&quot;:
  Stratifiers.&quot;By Education Level&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="9"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="ANCIND10"/>
        </extension>
        <extension url="name">
          <valueString value="Initial Population"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
Initial population: Antenatal clients
*/
define &quot;Initial Population&quot;:
  exists (BaseData.&quot;Antenatal care case&quot;)"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="10"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToString"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToString(value ProcedureStatus): value.value"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="11"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToInterval"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period.&quot;start&quot; is null then
            Interval(period.&quot;start&quot;.value, period.&quot;end&quot;.value]
        else
            Interval[period.&quot;start&quot;.value, period.&quot;end&quot;.value]"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="12"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToString"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToString(value ObservationStatus): value.value"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="13"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToBoolean"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToBoolean(value boolean): value.value"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="14"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="WHOCommon"/>
        </extension>
        <extension url="name">
          <valueString value="ModifierExtension"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@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)"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="15"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="WHOCommon"/>
        </extension>
        <extension url="name">
          <valueString value="ModifierExtensions"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@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"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="16"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToString"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToString(value uri): value.value"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="17"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToQuantity"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToQuantity(quantity FHIR.Quantity):
    case
        when quantity is null then null
        when quantity.value is null then null
        when quantity.comparator is not null then
            Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')
        when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'
              or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then
            System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }
        else
            Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' &amp; quantity.unit.value &amp; ' (' &amp; quantity.system.value &amp; '|' &amp; quantity.code.value &amp; ')')
    end"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="18"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToCalendarUnit"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToCalendarUnit(unit System.String):
    case unit
        when 'ms' then 'millisecond'
        when 's' then 'second'
        when 'min' then 'minute'
        when 'h' then 'hour'
        when 'd' then 'day'
        when 'wk' then 'week'
        when 'mo' then 'month'
        when 'a' then 'year'
        else unit
    end"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="19"/>
        </extension>
      </extension>
      <name value="EffectiveDataRequirements"/>
      <status value="active"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/library-type"/>
          <code value="module-definition"/>
        </coding>
      </type>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library PatientData"/>
        <resource value="http://smart.who.int/anc/Library/ANCDataElements"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library Cx"/>
        <resource value="http://smart.who.int/anc/Library/ANCConcepts"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library FHIRHelpers"/>
        <resource value="http://smart.who.int/anc/Library/FHIRHelpers|4.0.1"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library FC"/>
        <resource value="http://smart.who.int/anc/Library/FHIRCommon"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library BaseData"/>
        <resource
                  value="http://smart.who.int/anc/Library/ANCBaseDataElements"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library BCx"/>
        <resource value="http://smart.who.int/anc/Library/ANCBaseConcepts"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library Stratifiers"/>
        <resource value="http://smart.who.int/anc/Library/ANCStratifiers"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library WC"/>
        <resource value="http://smart.who.int/anc/Library/WHOCommon"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system ISO-8601-Derived Periods"/>
        <resource
                  value="http://ohie.org/CodeSystem/iso-8601-derived-periods"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Ultrasound scan conducted"/>
        <resource value="http://smart.who.int/anc/ValueSet/anc-b9-de3"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Antenatal care case"/>
        <resource
                  value="http://smart.who.int/anc/ValueSet/antenatal-care-case"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Gestational age"/>
        <resource value="http://smart.who.int/anc/ValueSet/anc-b6-de17"/>
      </relatedArtifact>
      <parameter>
        <name value="Measurement Period"/>
        <use value="in"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Period"/>
      </parameter>
      <parameter>
        <name value="Numerator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="Age Stratifier"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Coding"/>
      </parameter>
      <parameter>
        <name value="Denominator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="Education Level Stratifier"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="CodeableConcept"/>
      </parameter>
      <parameter>
        <name value="Initial Population"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <dataRequirement>
        <type value="Procedure"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
        <mustSupport value="code"/>
        <mustSupport value="status"/>
        <mustSupport value="performed"/>
        <codeFilter>
          <path value="code"/>
          <valueSet value="http://smart.who.int/anc/ValueSet/anc-b9-de3"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="EpisodeOfCare"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://smart.who.int/anc/ValueSet/antenatal-care-case"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Patient"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <mustSupport value="url"/>
        <mustSupport value="value"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
        <mustSupport value="code"/>
        <mustSupport value="status"/>
        <mustSupport value="effective"/>
        <mustSupport value="value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet value="http://smart.who.int/anc/ValueSet/anc-b6-de17"/>
        </codeFilter>
      </dataRequirement>
    </Library>
  </contained>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
    <valueReference>🔗 
      <reference value="Device/cqf-tooling"/>
    </valueReference>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
    <valueReference>🔗 
      <reference value="Device/cqf-tooling"/>
    </valueReference>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements" id="effective-data-requirements">
    <valueReference>
      <reference value="#effective-data-requirements"/>
    </valueReference>
  </extension>
  <url value="http://smart.who.int/anc/Measure/ANCIND10"/>
  <version value="0.3.0"/>
  <name value="ANCIND10"/>
  <title
         value="ANC.IND.10 Percentage of pregnant women with an ultrasound scan before 24 weeks"/>
  <status value="draft"/>
  <experimental value="false"/>
  <date value="2025-06-24T13:58:48-06:00"/>
  <publisher value="World Health Organization (WHO)"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="https://www.who.int"/>
    </telecom>
  </contact>
  <description
               value="Percentage of pregnant women with an ultrasound scan before 24 weeks"/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
    </coding>
  </jurisdiction>
  <library value="http://smart.who.int/anc/Library/ANCIND10"/>
  <scoring>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
      <code value="proportion"/>
    </coding>
  </scoring>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
      <code value="process"/>
    </coding>
  </type>
  <improvementNotation>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
      <code value="increase"/>
    </coding>
  </improvementNotation>
  <group id="group-1">
    <population id="initial-population">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="initial-population"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Initial Population"/>
      </criteria>
    </population>
    <population id="denominator">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Denominator"/>
      </criteria>
    </population>
    <population id="numerator">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="numerator"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Numerator"/>
      </criteria>
    </population>
    <stratifier id="by-age">
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Age Stratifier"/>
      </criteria>
    </stratifier>
    <stratifier id="by-education-level">
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Education Level Stratifier"/>
      </criteria>
    </stratifier>
  </group>
</Measure>