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 2025-06-24 |
<PlanDefinition xmlns="http://hl7.org/fhir">
<id value="ANCDT36"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<div>
<table class="grid dict">
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">ANCDT36</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-ANCDT36.html">ANC.DT.36 Intimate partner violence (IPV) clinical inquiry</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>
Official
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>ANC.DT.36</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">ANC.DT.36 Intimate partner violence (IPV) clinical inquiry</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://terminology.hl7.org/6.4.0/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;">2025-06-24 13:58:48-0600</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;"><div><p>You may suspect that a woman has been subjected to intimiate partner violence if she has any of the following risk factors</p>
</div></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>
</tr>
<tr>
<td>task</td>
<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-ANCDT36.html">ANC.DT.36 Intimate partner violence (IPV) clinical inquiry</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.36 Intimate partner violence (IPV) clinical inquiry:</b>
<br/>
<b>When:</b>
<i>Named Event:</i> ANC.B10.8. Intimate partner violence counselling
<br/>
<b>Then:</b>
<table class="grid-dict">
<tr>
<td>
Cultures and communities have ways of referring to the problem with other words. It is important to use the words that women themselves use.
<br/>
<b>If:</b>
<i>Applicability:</i>
(Minimum requirements for IPV assessment = TRUE
)
AND (Woman discloses or is suspected to be subjected to intimate partner violence = TRUE)
<i>(Should Conduct clinical enquiry)</i>
<br/>
</td>
</tr>
<tr>
<td>
WHO does not recommend universal screening for violence against women attending health care. WHO does encourage health-care providers to raise the topic with women who have injuries or conditions that they suspect may be related to violence.
Never raise the issue of partner violence unless a woman is alone. Even if she is with another woman, that woman could be the mother or sister of an abuser.
If you do ask her about violence, do it in an empathic, non-judgemental manner. Use language that is appropriate and relevant to the culture and community you are working in. Some women may not like the words “violence” and “abuse”
<br/>
<b>If:</b>
<i>Applicability:</i>
(Minimum requirements for IPV assessment = TRUE)
AND ("Presenting signs and symptoms that trigger suspicion of IPV and clinical inquiry" = "Ongoing stress")
<i>(Should Conduct clinical enquiry and provide first-line support and care if IPV confirmed)</i>
<br/>
</td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
</table>
</div>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<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 Config"/>
<resource value="http://smart.who.int/anc/Library/ANCConfig"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library ContactData"/>
<resource
value="http://smart.who.int/anc/Library/ANCContactDataElements"/>
</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="Value set Presenting signs and symptoms that trigger suspicion of IPV and clinical inquiry"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b7-de71"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Presenting signs and symptoms that trigger suspicion of IPV and clinical inquiry - Ongoing stress Choices"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b7-de72"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Woman discloses or is suspected to be subjected to intimate partner violence"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b7-de97"/>
</relatedArtifact>
<parameter>
<name value="encounter"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
</parameter>
<parameter>
<name
value="Should Conduct clinical enquiry and provide first-line support and care if IPV confirmed"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Should Conduct clinical enquiry"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="encounter"/>
<mustSupport value="encounter.reference"/>
<mustSupport value="value"/>
<codeFilter>
<path value="code"/>
<valueSet value="http://smart.who.int/anc/ValueSet/anc-b7-de71"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="encounter"/>
<mustSupport value="encounter.reference"/>
<codeFilter>
<path value="code"/>
<valueSet value="http://smart.who.int/anc/ValueSet/anc-b7-de97"/>
</codeFilter>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCConfig"/>
</extension>
<extension url="name">
<valueString value="Minimum requirements for IPV assessment"/>
</extension>
<extension url="statement">
<valueString
value="/*
Description: "WHO does not recommend universal screening for violence of
women attending health care. WHO does encourage health-care providers
to raise the topic with women who have injuries or conditions that they
suspect may be related to violence. All of the following must be in
place at the health facility for this to be TRUE:
a. A protocol or standard operating procedure for intimate partner
violence (IPV)
b. A health worker trained on how to ask about IPV and how to provide
the minimum response or beyond
c. A private setting
d. A way to ensure confidentiality
e. Time to allow for appropriate disclosure AND
f. A system for referral in place."
*/
define "Minimum requirements for IPV assessment":
true"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCContactDataElements"/>
</extension>
<extension url="name">
<valueString
value="Presenting signs and symptoms that trigger suspicion of IPV and clinical inquiry"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement: ANC.B7.DE71 Presenting signs and symptoms that trigger suspicion of IPV and clinical inquiry
@activity: ANC.B7 Symptoms & Follow-up
@description: Presenting signs and symptoms that trigger clinical enquiry of IPV. The Input Options listed below are based on Health care for women subjected to intimate partner violence or sexual violence – a clinical handbook (3)
*/
define "Presenting signs and symptoms that trigger suspicion of IPV and clinical inquiry":
[Observation: Cx."Presenting signs and symptoms that trigger suspicion of IPV and clinical inquiry"] O
where O.status in { 'final', 'amended', 'corrected' }
and Coalesce(WC.ModifierExtension(O, 'who-notDone').value, false) is false
and Last(Split(O.encounter.reference, '/')) = Last(Split(encounter, '/'))
return O.value as FHIR.CodeableConcept"/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT36"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct clinical enquiry and provide first-line support and care if IPV confirmed"/>
</extension>
<extension url="statement">
<valueString
value="/*
(Minimum requirements for IPV assessment = TRUE)
AND ("Presenting signs and symptoms that trigger suspicion of IPV and clinical inquiry" = "Ongoing stress")
*/
define "Should Conduct clinical enquiry and provide first-line support and care if IPV confirmed":
Config."Minimum requirements for IPV assessment" = true
and ContactData."Presenting signs and symptoms that trigger suspicion of IPV and clinical inquiry" in Cx."Presenting signs and symptoms that trigger suspicion of IPV and clinical inquiry - Ongoing stress Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCContactDataElements"/>
</extension>
<extension url="name">
<valueString
value="Woman discloses or is suspected to be subjected to intimate partner violence"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement: ANC.B7.DE97 Woman discloses or is suspected to be subjected to intimate partner violence
@activity: ANC.B7 Symptoms & Follow-up
@description: Woman discloses or is suspected to be subjected to intimate partner violence
*/
define "Woman discloses or is suspected to be subjected to intimate partner violence":
WC.Only(
[Observation: Cx."Woman discloses or is suspected to be subjected to intimate partner violence"] O
where O.status in { 'final', 'amended', 'corrected' }
and Coalesce(WC.ModifierExtension(O, 'who-notDone').value, false) is false
and Last(Split(O.encounter.reference, '/')) = Last(Split(encounter, '/'))
).value as FHIR.boolean"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT36"/>
</extension>
<extension url="name">
<valueString value="Should Conduct clinical enquiry"/>
</extension>
<extension url="statement">
<valueString
value="/*
(Minimum requirements for IPV assessment = TRUE
)
AND (Woman discloses or is suspected to be subjected to intimate partner violence = TRUE)
*/
define "Should Conduct clinical enquiry":
Config."Minimum requirements for IPV assessment" = true
and ContactData."Woman discloses or is suspected to be subjected to intimate partner violence" is true"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-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="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-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="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-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="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-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="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-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="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value string): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-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="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-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="12"/>
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url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="WHOCommon"/>
</extension>
<extension url="name">
<valueString value="Only"/>
</extension>
<extension url="statement">
<valueString
value="define function Only(observations List<Observation>):
singleton from observations"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements" id="effective-data-requirements">
<valueCanonical value="#effective-data-requirements"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem">
<valueReference>🔗
<reference value="Device/cqf-tooling"/>
</valueReference>
</extension>
<url value="http://smart.who.int/anc/PlanDefinition/ANCDT36"/>
<identifier>
<use value="official"/>
<value value="ANC.DT.36"/>
</identifier>
<version value="0.3.0"/>
<name value="ANCDT36"/>
<title value="ANC.DT.36 Intimate partner violence (IPV) clinical inquiry"/>
<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="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="You may suspect that a woman has been subjected to intimiate partner violence if she has any of the following risk factors"/>
<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://smart.who.int/anc/CodeSystem/activity-codes"/>
<code value="ANC.B10.8."/>
<display value="Intimate partner violence counselling"/>
</coding>
</valueCodeableConcept>
</useContext>
<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/ANCDT36"/>
<action>
<title
value="ANC.DT.36 Intimate partner violence (IPV) clinical inquiry"/>
<trigger>
<type value="named-event"/>
<name value="ANC.B10.8. Intimate partner violence counselling"/>
</trigger>
<action id="1">
<title value="Conduct clinical enquiry"/>
<description value="Conduct clinical enquiry"/>
<textEquivalent
value="Cultures and communities have ways of referring to the problem with other words. It is important to use the words that women themselves use."/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): B1.3 (2)
IPV handbook (2014) (12)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="(Minimum requirements for IPV assessment = TRUE
)
AND (Woman discloses or is suspected to be subjected to intimate partner violence = TRUE)"/>
<language value="text/cql-identifier"/>
<expression value="Should Conduct clinical enquiry"/>
</expression>
</condition>
</action>
<action id="2">
<title
value="Conduct clinical enquiry and provide first-line support and care if IPV confirmed"/>
<description
value="Conduct clinical enquiry and provide first-line support and care if IPV confirmed"/>
<textEquivalent
value="WHO does not recommend universal screening for violence against women attending health care. WHO does encourage health-care providers to raise the topic with women who have injuries or conditions that they suspect may be related to violence.
Never raise the issue of partner violence unless a woman is alone. Even if she is with another woman, that woman could be the mother or sister of an abuser.
If you do ask her about violence, do it in an empathic, non-judgemental manner. Use language that is appropriate and relevant to the culture and community you are working in. Some women may not like the words “violence” and “abuse”"/>
<documentation>
<type value="citation"/>
<label value="IPV handbook (2014) (15)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="(Minimum requirements for IPV assessment = TRUE)
AND ("Presenting signs and symptoms that trigger suspicion of IPV and clinical inquiry" = "Ongoing stress")"/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct clinical enquiry and provide first-line support and care if IPV confirmed"/>
</expression>
</condition>
</action>
</action>
</PlanDefinition>