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="ANCDT08"/>
<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;">ANCDT08</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-ANCDT08.html">ANC.DT.08 HIV testing</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.08</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">ANC.DT.08 HIV testing</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>Depending on the population prevalence, and woman's medical history, conduct HIV testing</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-ANCDT08.html">ANC.DT.08 HIV testing</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.08 HIV testing:</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>
In high-prevalence settings, provider-initiated testing and counselling (PITC) for HIV should be considered a routine component of the package of care for pregnant women in all ANC settings
An HIV test is required for all pregnant women at the first contact in pregnancy if the HIV prevalence in the pregnant woman population is 5% or higher.
<br/>
<b>If:</b>
<i>Applicability:</i>
("Population prevalence of HIV in pregnant women" ≥ 5%)
AND ("ANC contact number" = 1)
<i>(Should Conduct HIV test)</i>
<br/>
</td>
</tr>
<tr>
<td>
Another HIV test is required for all pregnant women at the first contact of the 3rd trimester (28 weeks), if the HIV prevalence in the pregnant woman population is 5% or higher
<br/>
<b>If:</b>
<i>Applicability:</i>
("Population prevalence of HIV in pregnant women" ≥ 5%)
AND ("Gestational age" ≥ 29 weeks)
AND ("HIV status" = "HIV negative")
<i>(Should Conduct HIV test 2)</i>
<br/>
</td>
</tr>
<tr>
<td>
In low-prevalence settings, provider-initiated testing and counselling (PITC) can be considered for pregnant women in ANC settings as a key component of the effort to eliminate mother-to-child transmission of HIV, and to integrate HIV testing with syphilis, viral or other key tests, as relevant to the setting, and to strengthen the underlying maternal and child health systems
<br/>
<b>If:</b>
<i>Applicability:</i>
"Population prevalence of HIV in pregnant women" < 5%
<i>(Should HIV test is optional)</i>
<br/>
</td>
</tr>
<tr>
<td>
A test is not required if the woman is already confirmed HIV positive
<br/>
<b>If:</b>
<i>Applicability:</i>
"HIV status" = "HIV positive"
<i>(Should HIV test is not required)</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 FHIRHelpers"/>
<resource value="http://smart.who.int/anc/Library/FHIRHelpers|4.0.1"/>
</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 WC"/>
<resource value="http://smart.who.int/anc/Library/WHOCommon"/>
</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 Config"/>
<resource value="http://smart.who.int/anc/Library/ANCConfig"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library AC"/>
<resource value="http://smart.who.int/anc/Library/ANCCommon"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set HIV status"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b9-de45"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set HIV status - HIV positive Choices"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b9-de46"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Gestational age"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b6-de17"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set HIV status - HIV negative Choices"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b9-de47"/>
</relatedArtifact>
<parameter>
<name value="encounter"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
</parameter>
<parameter>
<name value="Should HIV test is not required"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Should Conduct HIV test 2"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Should Conduct HIV test"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Should HIV test is optional"/>
<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"/>
<codeFilter>
<path value="code"/>
<valueSet value="http://smart.who.int/anc/ValueSet/anc-b9-de45"/>
</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-b6-de17"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
<mustSupport value="id"/>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCContactDataElements"/>
</extension>
<extension url="name">
<valueString value="HIV status"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement: ANC.B9.DE45 HIV status
@activity: ANC.B9 Lab tests & imaging
@description: Calculated field for woman's HIV status
*/
define "HIV status":
WC.Only(
[Observation: Cx."HIV status"] 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.CodeableConcept"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT08"/>
</extension>
<extension url="name">
<valueString value="Should HIV test is not required"/>
</extension>
<extension url="statement">
<valueString
value="/*
"HIV status" = "HIV positive"
*/
define "Should HIV test is not required":
ContactData."HIV status" in Cx."HIV status - HIV positive Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCConfig"/>
</extension>
<extension url="name">
<valueString value="Population prevalence of HIV in pregnant women"/>
</extension>
<extension url="statement">
<valueString
value="/*
Description: The proportion of pregnant women in the population who are
HIV positive
*/
define "Population prevalence of HIV in pregnant women":
6 '%'"/>
</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="Gestational age"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement: ANC.B6.DE17 Gestational age
@activity: ANC.B6 Profile
@description: Gestational age in weeks and/or days depending on the source of gestational age
*/
define "Gestational age":
WC.MostRecent(
[Observation: Cx."Gestational age"] 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.Quantity"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT08"/>
</extension>
<extension url="name">
<valueString value="Should Conduct HIV test 2"/>
</extension>
<extension url="statement">
<valueString
value="/*
("Population prevalence of HIV in pregnant women" ≥ 5%)
AND ("Gestational age" ≥ 29 weeks)
AND ("HIV status" = "HIV negative")
*/
define "Should Conduct HIV test 2":
Config."Population prevalence of HIV in pregnant women" >= 5 '%'
and ContactData."Gestational age" >= 29 'weeks'
and ContactData."HIV status" in Cx."HIV status - HIV negative Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCContactDataElements"/>
</extension>
<extension url="name">
<valueString value="ANC contact number"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement: ANC.A.DE12 ANC contact number
@activity: ANC.A4 Gather client details
@description: The ANC contact or visit number – recommended minimum is 8 contacts
*/
define "ANC contact number":
AC.Extension(WC.Only(
[Encounter] E
where E.id = Last(Split(encounter, '/'))
), 'contactNumber').value as integer"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT08"/>
</extension>
<extension url="name">
<valueString value="Should Conduct HIV test"/>
</extension>
<extension url="statement">
<valueString
value="/*
("Population prevalence of HIV in pregnant women" ≥ 5%)
AND ("ANC contact number" = 1)
*/
define "Should Conduct HIV test":
Config."Population prevalence of HIV in pregnant women" >= 5 '%'
and (ContactData."ANC contact number" = 1)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT08"/>
</extension>
<extension url="name">
<valueString value="Should HIV test is optional"/>
</extension>
<extension url="statement">
<valueString
value="/*
"Population prevalence of HIV in pregnant women" < 5%
*/
define "Should HIV test is optional":
Config."Population prevalence of HIV in pregnant women" < 5 '%'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</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="8"/>
</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="9"/>
</extension>
</extension>
<extension
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="10"/>
</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="11"/>
</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="12"/>
</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="13"/>
</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="14"/>
</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="15"/>
</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="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-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: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')')
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-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="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="WHOCommon"/>
</extension>
<extension url="name">
<valueString value="MostRecent"/>
</extension>
<extension url="statement">
<valueString
value="define function MostRecent(observations List<Observation>):
Last(
observations O
sort by issued
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToInteger"/>
</extension>
<extension url="statement">
<valueString
value="define function ToInteger(value integer): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCCommon"/>
</extension>
<extension url="name">
<valueString value="Extension"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the single ANC 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 id.
*/
define function Extension(domainResource DomainResource, id String):
singleton from "Extensions"(domainResource, id)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCCommon"/>
</extension>
<extension url="name">
<valueString value="Extensions"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns any ANC 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 Extensions(domainResource DomainResource, id String):
domainResource.extension E
where E.url = ('http://smart.who.int/anc/StructureDefinition/' + id)
return E"/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
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(encounters List<Encounter>):
singleton from encounters"/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</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/ANCDT08"/>
<identifier>
<use value="official"/>
<value value="ANC.DT.08"/>
</identifier>
<version value="0.3.0"/>
<name value="ANCDT08"/>
<title value="ANC.DT.08 HIV testing"/>
<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="Depending on the population prevalence, and woman's medical history, conduct HIV testing"/>
<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.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://smart.who.int/anc/Library/ANCDT08"/>
<action>
<title value="ANC.DT.08 HIV testing"/>
<trigger>
<type value="named-event"/>
<name value="ANC.B9. Conduct laboratory tests and imaging"/>
</trigger>
<action id="1">
<title value="Conduct HIV test"/>
<description value="Conduct HIV test"/>
<textEquivalent
value="In high-prevalence settings, provider-initiated testing and counselling (PITC) for HIV should be considered a routine component of the package of care for pregnant women in all ANC settings
An HIV test is required for all pregnant women at the first contact in pregnancy if the HIV prevalence in the pregnant woman population is 5% or higher."/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): B.1.7. Human immunodeficiency virus (HIV) and syphilis (3)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="("Population prevalence of HIV in pregnant women" ≥ 5%)
AND ("ANC contact number" = 1)"/>
<language value="text/cql-identifier"/>
<expression value="Should Conduct HIV test"/>
</expression>
</condition>
</action>
<action id="2">
<title value="Conduct HIV test"/>
<description value="Conduct HIV test 2"/>
<textEquivalent
value="Another HIV test is required for all pregnant women at the first contact of the 3rd trimester (28 weeks), if the HIV prevalence in the pregnant woman population is 5% or higher"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): B.1.7. Human immunodeficiency virus (HIV) and syphilis (3)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="("Population prevalence of HIV in pregnant women" ≥ 5%)
AND ("Gestational age" ≥ 29 weeks)
AND ("HIV status" = "HIV negative")"/>
<language value="text/cql-identifier"/>
<expression value="Should Conduct HIV test 2"/>
</expression>
</condition>
</action>
<action id="3">
<title value="HIV test is optional"/>
<description value="HIV test is optional"/>
<textEquivalent
value="In low-prevalence settings, provider-initiated testing and counselling (PITC) can be considered for pregnant women in ANC settings as a key component of the effort to eliminate mother-to-child transmission of HIV, and to integrate HIV testing with syphilis, viral or other key tests, as relevant to the setting, and to strengthen the underlying maternal and child health systems"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): B.1.7. Human immunodeficiency virus (HIV) and syphilis (3)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value=""Population prevalence of HIV in pregnant women" < 5%"/>
<language value="text/cql-identifier"/>
<expression value="Should HIV test is optional"/>
</expression>
</condition>
</action>
<action id="4">
<title value="HIV test is not required"/>
<description value="HIV test is not required"/>
<textEquivalent
value="A test is not required if the woman is already confirmed HIV positive"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): B.1.7. Human immunodeficiency virus (HIV) and syphilis (3)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value=""HIV status" = "HIV positive""/>
<language value="text/cql-identifier"/>
<expression value="Should HIV test is not required"/>
</expression>
</condition>
</action>
</action>
</PlanDefinition>