WHO Antenatal Care Guideline Implementation Guide
0.3.0 - CI Build
WHO Antenatal Care Guideline Implementation Guide
0.3.0 - CI Build
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
| Draft as of 2025-06-24 |
<Measure xmlns="http://hl7.org/fhir">
<id value="ANCIND12"/>
<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">ANCIND12</td>
</tr>
<tr>
<th scope="row" class="row-header">Title (human-readable)</th>
<td class="content-container">ANC.IND.12 Percentage of pregnant women counselled and tested for HIV</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 counselled and tested for HIV</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="#ancind12-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="#ancind12-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="#ancind12-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-ANCIND12.html">ANC.IND.12 Percentage of pregnant women counselled and tested for HIV</a></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 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 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>: 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>: 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 Reason for closing ANC record
<br/>
<em>Resource</em>: <a href="ValueSet-anc-end-1.html">Reason for closing ANC record</a>
<br/>
<em>Canonical URL</em>: <tt>http://smart.who.int/anc/ValueSet/anc-end-1</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Value set Qualifying Reason for closing ANC record Choices
<br/>
<em>Resource</em>: <a href="ValueSet-qualifying-reason-for-closing-anc-record-choices.html">Qualifying Reason for closing ANC record Choices</a>
<br/>
<em>Canonical URL</em>: <tt>http://smart.who.int/anc/ValueSet/qualifying-reason-for-closing-anc-record-choices</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">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>: 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-end-1.html">Reason for closing ANC record</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 colspan="2" scope="row" class="row-header">Measure Logic Definitions</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="ancind12-numerator"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> ANCIND12</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
Numerator: Number of pregnant women attending ANC who received counselling and testing for HIV during pregnancy
Numerator Computation: COUNT of all women who received provider-initiated counselling and testing (PICT)
*/
define Numerator:
// TODO: It's not clear which of these data elements constitute PICT?
// @dataElement: ANC.B9.DE34 HIV test ordered
// @dataElement: ANC.B9.DE41 HIV test result
// @dataElement: ANC.B9.DE45 HIV status
// @dataElement: ANC.B9.DE35 HIV test conducted
// @dataElement: ANC.B10.DE78 Counselling conducted on HIV positive
// @dataElement: ANC.B10.DE125 Counselling conducted on HIV risk
// @dataElement: ANC.B10.DE126 PrEP for HIV prevention provided
// Is it all or any of these, or other data elements?
false</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 "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</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="ancind12-age-stratifier"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> ANCIND12</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 "Age Stratifier":
Stratifiers."By Age"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="ancdataelements-reason-for-closing-anc-record"> </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.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</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="ancind12-denominator"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> ANCIND12</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 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"
)</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 "By Education Level":
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="ancind12-education-level-stratifier"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> ANCIND12</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 "Education Level Stratifier":
Stratifiers."By Education Level"</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 "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"]</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="ancind12-initial-population"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> ANCIND12</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
Initial population: Antenatal clients
*/
define "Initial Population":
exists (BaseData."Antenatal care case")</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-toconcept"> </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 ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="fhirhelpers-tocode"> </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 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
}</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="ANCIND12"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="/*
Numerator: Number of pregnant women attending ANC who received counselling and testing for HIV during pregnancy
Numerator Computation: COUNT of all women who received provider-initiated counselling and testing (PICT)
*/
define Numerator:
// TODO: It's not clear which of these data elements constitute PICT?
// @dataElement: ANC.B9.DE34 HIV test ordered
// @dataElement: ANC.B9.DE41 HIV test result
// @dataElement: ANC.B9.DE45 HIV status
// @dataElement: ANC.B9.DE35 HIV test conducted
// @dataElement: ANC.B10.DE78 Counselling conducted on HIV positive
// @dataElement: ANC.B10.DE125 Counselling conducted on HIV risk
// @dataElement: ANC.B10.DE126 PrEP for HIV prevention provided
// Is it all or any of these, or other data elements?
false"/>
</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="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 "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"/>
</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="ANCIND12"/>
</extension>
<extension url="name">
<valueString value="Age Stratifier"/>
</extension>
<extension url="statement">
<valueString
value="/*
Disaggregation: Age (10-14, 15-19, 20+)
*/
define "Age Stratifier":
Stratifiers."By Age""/>
</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="ANCDataElements"/>
</extension>
<extension url="name">
<valueString value="Reason for closing ANC record"/>
</extension>
<extension url="statement">
<valueString
value="/*
@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"/>
</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="ANCIND12"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="/*
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"
)"/>
</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="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 "By Education Level":
Patient.extension E
where E.url = 'http://smart.who.int/anc/StructureDefinition/educationlevel'
return E.value as CodeableConcept"/>
</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="ANCIND12"/>
</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 "Education Level Stratifier":
Stratifiers."By Education Level""/>
</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="ANCBaseDataElements"/>
</extension>
<extension url="name">
<valueString value="Antenatal care case"/>
</extension>
<extension url="statement">
<valueString
value="/*
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"]"/>
</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="ANCIND12"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="/*
Initial population: Antenatal clients
*/
define "Initial Population":
exists (BaseData."Antenatal care case")"/>
</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="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="9"/>
</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="10"/>
</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="11"/>
</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="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 uri): 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="ToConcept"/>
</extension>
<extension url="statement">
<valueString
value="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
}"/>
</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="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToCode"/>
</extension>
<extension url="statement">
<valueString
value="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
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</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 Stratifiers"/>
<resource value="http://smart.who.int/anc/Library/ANCStratifiers"/>
</relatedArtifact>
<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 WC"/>
<resource value="http://smart.who.int/anc/Library/WHOCommon"/>
</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="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 Reason for closing ANC record"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-end-1"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Qualifying Reason for closing ANC record Choices"/>
<resource
value="http://smart.who.int/anc/ValueSet/qualifying-reason-for-closing-anc-record-choices"/>
</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>
<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="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-end-1"/>
</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>
</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/ANCIND12"/>
<version value="0.3.0"/>
<name value="ANCIND12"/>
<title
value="ANC.IND.12 Percentage of pregnant women counselled and tested for HIV"/>
<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 counselled and tested for HIV"/>
<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/ANCIND12"/>
<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>