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="ANCDT11"/>
<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;">ANCDT11</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-ANCDT11.html">ANC.DT.11 Syphilis 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.11</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">ANC.DT.11 Syphilis 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 contact schedule, and woman's syphilis diagnosis, test for syphilis</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-ANCDT11.html">ANC.DT.11 Syphilis 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.11 Syphilis 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>
A syphilis test is recommended for all pregnant women at the first contact
<br/>
<b>If:</b>
<i>Applicability:</i>
"ANC contact number" = 1
<i>(Should Conduct syphilis test)</i>
<br/>
</td>
</tr>
<tr>
<td>
A syphilis test is recommended again at the first contact of 3rd trimester (28 weeks)
<br/>
<b>If:</b>
<i>Applicability:</i>
"Gestational age" ≥ 29 weeks
<i>(Should Conduct syphilis test 2)</i>
<br/>
</td>
</tr>
<tr>
<td>
Women who are already confirmed positive for syphilis do not need to be tested
<br/>
<b>If:</b>
<i>Applicability:</i>
"Syphilis diagnosis" = "Syphilis positive"
<i>(Should No syphilis test required )</i>
<br/>
<b>Then:</b> <i>Additional sub-actions not displayed</i>
</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 AC"/>
<resource value="http://smart.who.int/anc/Library/ANCCommon"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Syphilis diagnosis"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b9-de110"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Syphilis diagnosis - Syphilis positive Choices"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b9-de111"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Gestational age"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b6-de17"/>
</relatedArtifact>
<parameter>
<name value="encounter"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
</parameter>
<parameter>
<name value="Should No syphilis test required "/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Should Conduct syphilis test 2"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Should Conduct syphilis test"/>
<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-de110"/>
</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="Syphilis diagnosis"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement: ANC.B9.DE110 Syphilis diagnosis
@activity: ANC.B9 Lab tests & imaging
@description: Calculation for whether woman has syphilis (1) or not (0)
*/
define "Syphilis diagnosis":
WC.Only(
[Observation: Cx."Syphilis diagnosis"] 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="ANCDT11"/>
</extension>
<extension url="name">
<valueString value="Should No syphilis test required "/>
</extension>
<extension url="statement">
<valueString
value="/*
"Syphilis diagnosis" = "Syphilis positive"
*/
define "Should No syphilis test required ":
ContactData."Syphilis diagnosis" in Cx."Syphilis diagnosis - Syphilis 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="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="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT11"/>
</extension>
<extension url="name">
<valueString value="Should Conduct syphilis test 2"/>
</extension>
<extension url="statement">
<valueString
value="/*
"Gestational age" ≥ 29 weeks
*/
define "Should Conduct syphilis test 2":
ContactData."Gestational age" >= 29 'weeks'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</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="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT11"/>
</extension>
<extension url="name">
<valueString value="Should Conduct syphilis test"/>
</extension>
<extension url="statement">
<valueString
value="/*
"ANC contact number" = 1
*/
define "Should Conduct syphilis test":
ContactData."ANC contact number" = 1"/>
</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="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="6"/>
</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="7"/>
</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="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 ObservationStatus): 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="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/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="11"/>
</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="12"/>
</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="13"/>
</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="14"/>
</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="15"/>
</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="16"/>
</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="17"/>
</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="18"/>
</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="19"/>
</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="20"/>
</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="21"/>
</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/ANCDT11"/>
<identifier>
<use value="official"/>
<value value="ANC.DT.11"/>
</identifier>
<version value="0.3.0"/>
<name value="ANCDT11"/>
<title value="ANC.DT.11 Syphilis 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 contact schedule, and woman's syphilis diagnosis, test for syphilis"/>
<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/ANCDT11"/>
<action>
<title value="ANC.DT.11 Syphilis testing"/>
<trigger>
<type value="named-event"/>
<name value="ANC.B9. Conduct laboratory tests and imaging"/>
</trigger>
<action id="1">
<title value="Conduct syphilis test"/>
<description value="Conduct syphilis test"/>
<textEquivalent
value="A syphilis test is recommended for all pregnant women at the first contact"/>
<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=""ANC contact number" = 1"/>
<language value="text/cql-identifier"/>
<expression value="Should Conduct syphilis test"/>
</expression>
</condition>
</action>
<action id="2">
<title value="Conduct syphilis test"/>
<description value="Conduct syphilis test 2"/>
<textEquivalent
value="A syphilis test is recommended again at the first contact of 3rd trimester (28 weeks)"/>
<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=""Gestational age" ≥ 29 weeks"/>
<language value="text/cql-identifier"/>
<expression value="Should Conduct syphilis test 2"/>
</expression>
</condition>
</action>
<action id="3">
<title value="No syphilis test required "/>
<description value="No syphilis test required "/>
<textEquivalent
value="Women who are already confirmed positive for syphilis do not need to be tested"/>
<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=""Syphilis diagnosis" = "Syphilis positive""/>
<language value="text/cql-identifier"/>
<expression value="Should No syphilis test required "/>
</expression>
</condition>
<action>
<title value="No syphilis test required "/>
</action>
<action>
<title value="Provide counselling and treatment"/>
</action>
</action>
</action>
</PlanDefinition>