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
| Active as of 2021-06-11 |
<PlanDefinition xmlns="http://hl7.org/fhir">
<id value="ANCDT29"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="grid dict">
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">ANCDT29</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-ANCDT29.html">ANC.DT.29 HIV risk counselling</a></td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">0.3.0</td>
</tr>
<tr>
<th scope="row"><b>Identifier: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<b>value: </b> <span>ANC.DT.29</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Name: </b></th>
<td style="padding-left: 4px;">ANCDT29</td>
</tr>
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">ANC.DT.29 HIV risk counselling</td>
</tr>
<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">active</td>
</tr>
<tr>
<th scope="row"><b>Experimental: </b></th>
<td style="padding-left: 4px;">false</td>
</tr>
<tr>
<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<b>system: </b> <span><a href="http://hl7.org/fhir/R4/codesystem-plan-definition-type.html">http://terminology.hl7.org/CodeSystem/plan-definition-type</a></span>
</p>
<p style="margin-bottom: 5px;">
<b>code: </b> <span>eca-rule</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Date: </b></th>
<td style="padding-left: 4px;">2021-06-11 23:42:28-0600</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">World Health Organization (WHO)</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;">If the woman has risk factors for contracting HIV, provide counselling to reduce risk of contracting HIV</td>
</tr>
<tr>
<th scope="row"><b>Use Context: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr><th><b>code</b></th><th><b>value</b></th><th><b>display</b></th></tr>
<tr>
<td>task</td>
<td>ANC.B9.</td>
<td>Conduct laboratory tests and imaging</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Jurisdiction: </b></th>
<td style="padding-left: 4px;">001</td>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr><td><a href="Library-ANCDT29.html">ANC.DT.29 HIV risk counselling</a></td></tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Actions: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td>
<b> ANC.DT.29 HIV risk counselling:</b> <br/>
<b>When:</b> <i>Named Event:</i> ANC.B9. Conduct laboratory tests and imaging<br/>
<b>Then:</b>
<table class="grid-dict">
<tr>
<td>
If the woman lives in a setting with a generalized HIV epidemic, or her partner is HIV positive, or she injects drugs, or she is a sex worker, then she is at high risk for HIV – counselling should be given to provide prevention options
Provide comprehensive HIV prevention options:
– STI screening and treatment (syndromic and syphilis)
– Condom promotion
– Risk reduction counselling
– Pre-exposure prophylaxis (PrEP) with emphasis on adherence
– Emphasize importance of follow-up ANC contact visits<br/>
<b>If:</b> <i>Applicability:</i> ((((((&quot;HIV status&quot; = &quot;HIV negative&quot;)
AND (&quot;Prevalence of HIV in pregnant women in the catchment area&quot; &gt; 1%))
OR ((&quot;HIV status&quot; = &quot;HIV negative&quot;)
AND (&quot;Partner HIV status (reported)&quot; = &quot;HIV positive&quot;)))
OR ((&quot;HIV status&quot; = &quot;HIV negative&quot;)
AND (&quot;Partner HIV test result&quot; = HIV positive&quot;)))
OR ((&quot;HIV status&quot; = &quot;HIV negative&quot;)
AND (Partner HIV status (confirmed)&quot; = &quot;HIV positive&quot;)))
OR ((&quot;HIV status&quot; = &quot;HIV negative&quot;)
AND (Current alcohol and/or other substance use&quot; = &quot;Injectable drugs&quot;)))
OR ((&quot;HIV status&quot; = &quot;HIV negative&quot;)
AND (&quot;Occupation&quot; = &quot;Employment that puts woman at increased risk for HIV (e.g. sex worker)&quot;)) <i>(Should Conduct counselling on HIV risk)</i><br/>
</td>
</tr>
<tr>
<td>
Oral pre-exposure prophylaxis (PrEP) containing tenofovir disoproxil fumarate (TDF) should be offered as an additional prevention choice for pregnant women at substantial risk of HIV infection as part of combination prevention approaches.
See &quot;PrEP offering framework&quot; – a suggested prioritization framework for offering PrEP to pregnant and breastfeeding women (below).<br/>
<b>If:</b> <i>Applicability:</i> &quot;Population incidence of HIV in the absence of PrEP&quot; &gt; 3 per 100 person-years <i>(Should Conduct counselling on pre-exposure prophylaxis (PrEP) for HIV prevention)</i><br/>
</td>
</tr>
<tr>
<td>
Encourage woman to find out the status of her partner(s) or to bring them during the next contact visit to get tested<br/>
<b>If:</b> <i>Applicability:</i> (&quot;Partner HIV status (reported)&quot; = &quot;Inconclusive&quot;)
OR (&quot;Partner HIV test conducted&quot; = FALSE) <i>(Should Conduct counselling on HIV risk 2)</i><br/>
<b>Then:</b>
<table class="grid-dict">
<tr>
<td>
<b> Conduct counselling on HIV risk:</b> <br/>
</td>
</tr>
<tr>
<td>
<b> Recommended partner HIV test:</b> <br/>
</td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
</table>
</div>
</text>
<url value="http://fhir.org/guides/who/anc-cds/PlanDefinition/ANCDT29"/>
<identifier>
<use value="official"/>
<value value="ANC.DT.29"/>
</identifier>
<version value="0.3.0"/>
<name value="ANCDT29"/>
<title value="ANC.DT.29 HIV risk counselling"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/>
<code value="eca-rule"/>
</coding>
</type>
<status value="active"/>
<experimental value="false"/>
<date value="2021-06-11T23:42:28-06:00"/>
<publisher value="World Health Organization (WHO)"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.who.int"/>
</telecom>
</contact>
<description
value="If the woman has risk factors for contracting HIV, provide counselling to reduce risk of contracting HIV"/>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="task"/>
<display value="Workflow Task"/>
</code>
<valueCodeableConcept>
<coding>
<system
value="http://fhir.org/guides/who/anc-cds/CodeSystem/activity-codes"/>
<code value="ANC.B9."/>
<display value="Conduct laboratory tests and imaging"/>
</coding>
</valueCodeableConcept>
</useContext>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
</coding>
</jurisdiction>
<library value="http://fhir.org/guides/who/anc-cds/Library/ANCDT29"/>
<action>
<title value="ANC.DT.29 HIV risk counselling"/>
<trigger>
<type value="named-event"/>
<name value="ANC.B9. Conduct laboratory tests and imaging"/>
</trigger>
<action id="1">
<title value="Conduct counselling on HIV risk"/>
<description value="Conduct counselling on HIV risk"/>
<textEquivalent
value="If the woman lives in a setting with a generalized HIV epidemic, or her partner is HIV positive, or she injects drugs, or she is a sex worker, then she is at high risk for HIV – counselling should be given to provide prevention options
Provide comprehensive HIV prevention options:
– STI screening and treatment (syndromic and syphilis)
– Condom promotion
– Risk reduction counselling
– Pre-exposure prophylaxis (PrEP) with emphasis on adherence
– Emphasize importance of follow-up ANC contact visits"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): B.1.7, C.7 (2)
Pregnancy, childbirth, postpartum and newborn care guide (IMPAC) (2015): C6 (1)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="(((((("HIV status" = "HIV negative")
AND ("Prevalence of HIV in pregnant women in the catchment area" > 1%))
OR (("HIV status" = "HIV negative")
AND ("Partner HIV status (reported)" = "HIV positive")))
OR (("HIV status" = "HIV negative")
AND ("Partner HIV test result" = HIV positive")))
OR (("HIV status" = "HIV negative")
AND (Partner HIV status (confirmed)" = "HIV positive")))
OR (("HIV status" = "HIV negative")
AND (Current alcohol and/or other substance use" = "Injectable drugs")))
OR (("HIV status" = "HIV negative")
AND ("Occupation" = "Employment that puts woman at increased risk for HIV (e.g. sex worker)"))"/>
<language value="text/cql-identifier"/>
<expression value="Should Conduct counselling on HIV risk"/>
</expression>
</condition>
</action>
<action id="2">
<title
value="Conduct counselling on pre-exposure prophylaxis (PrEP) for HIV prevention"/>
<description
value="Conduct counselling on pre-exposure prophylaxis (PrEP) for HIV prevention"/>
<textEquivalent
value="Oral pre-exposure prophylaxis (PrEP) containing tenofovir disoproxil fumarate (TDF) should be offered as an additional prevention choice for pregnant women at substantial risk of HIV infection as part of combination prevention approaches.
See "PrEP offering framework" – a suggested prioritization framework for offering PrEP to pregnant and breastfeeding women (below)."/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): C.7 (2)
Pre-exposure prophylaxis (PrEP) for HIV prevention (2017) (20)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value=""Population incidence of HIV in the absence of PrEP" > 3 per 100 person-years"/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct counselling on pre-exposure prophylaxis (PrEP) for HIV prevention"/>
</expression>
</condition>
</action>
<action id="3">
<title value="Conduct counselling on HIV risk"/>
<description value="Conduct counselling on HIV risk 2"/>
<textEquivalent
value="Encourage woman to find out the status of her partner(s) or to bring them during the next contact visit to get tested"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): B.1.7 (2)
Consolidated guidelines on HIV testing services (2015) (6)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="("Partner HIV status (reported)" = "Inconclusive")
OR ("Partner HIV test conducted" = FALSE)"/>
<language value="text/cql-identifier"/>
<expression value="Should Conduct counselling on HIV risk 2"/>
</expression>
</condition>
<action>
<title value="Conduct counselling on HIV risk"/>
</action>
<action>
<title value="Recommended partner HIV test"/>
</action>
</action>
</action>
</PlanDefinition>