WHO Antenatal Care Guideline Implementation Guide
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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

: ANC.DT.32 Tetanus toxoid-containing vaccination - XML Representation

Active as of 2025-06-24

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<PlanDefinition xmlns="http://hl7.org/fhir">
  <id value="ANCDT32"/>
  <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;">ANCDT32</td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Url: </b></th>
            <td style="padding-left: 4px;"><a href="PlanDefinition-ANCDT32.html">ANC.DT.32 Tetanus toxoid-containing vaccination</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.32</span>
                </p>
                
            </td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Title: </b></th>
            <td style="padding-left: 4px;">ANC.DT.32 Tetanus toxoid-containing vaccination</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>If the woman has not yet been fully immunized against tetanus, she should be immunized</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-ANCDT32.html">ANC.DT.32 Tetanus toxoid-containing vaccination</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.32 Tetanus toxoid-containing vaccination:</b> 
                            
                            <br/>
                            
                            <b>When:</b>
                            
                            <i>Named Event:</i> ANC.B10.7. Immunizations
                            <br/>
                            
                            
                            
                            
                            <b>Then:</b>
                            <table class="grid-dict">
                                
                                <tr>
                                    <td>
                                        
                                        Tetanus toxoid (TT) vaccination is recommended for all pregnant women who are not fully immunised against TT to prevent neonatal mortality from tetanus
                                        
                                        <br/>
                                        
                                        
                                        <b>If:</b>
                                        
                                        <i>Applicability:</i>
                                        
                                        ((&quot;Tetanus toxoid-containing vaccine (TTCV) immunization history&quot; = &quot;Under-immunized&quot;)
  OR (&quot;Tetanus toxoid-containing vaccine (TTCV) immunization history&quot; = &quot;No doses&quot;))
  OR (&quot;Tetanus toxoid-containing vaccine (TTCV) immunization history&quot; = &quot;Unknown&quot;)
                                        
                                        <i>(Should Provide tetanus toxoid immunizations – using the \&quot;Tetanus toxoid-containing vaccine (TTCV) immunization – NO PREVIOUS\&quot; schedule (3 dose scheme))</i>
                                        <br/>
                                        
                                        
                                        
                                        
                                        
                                    </td>
                                </tr>
                                
                                <tr>
                                    <td>
                                        
                                        1–4 doses of TTCV in the past:
– 1 dose scheme: Woman should receive one dose of TTCV during each subsequent pregnancy to a total of five doses (five doses protects throughout the childbearing years)
                                        
                                        <br/>
                                        
                                        
                                        <b>If:</b>
                                        
                                        <i>Applicability:</i>
                                        
                                        ((((&quot;Tetanus toxoid-containing vaccine (TTCV) 1 immunization provided&quot; = TRUE)
  AND (&quot;Tetanus toxoid-containing vaccine (TTCV) 2 immunization provided&quot; = TRUE)
  AND (&quot;Tetanus toxoid-containing vaccine (TTCV) 3 immunization provided&quot; = TRUE)
  AND (&quot;Tetanus toxoid-containing vaccine (TTCV) 4 immunization provided&quot; =  TRUE))
  OR ((&quot;Tetanus toxoid-containing vaccine (TTCV) 1 immunization provided&quot; = TRUE)
  AND (&quot;Tetanus toxoid-containing vaccine (TTCV) 2 immunization provided&quot; = TRUE)
  AND (&quot;Tetanus toxoid-containing vaccine (TTCV) 3 immunization provided&quot; = TRUE)))
  OR ((&quot;Tetanus toxoid-containing vaccine (TTCV) 1 immunization provided&quot; = TRUE)
  AND (&quot;Tetanus toxoid-containing vaccine (TTCV) 2 immunization provided&quot; = TRUE)))
  OR (&quot;Tetanus toxoid-containing vaccine (TTCV) 1 immunization provided&quot; = TRUE)
                                        
                                        <i>(Should Provide tetanus toxoid immunizations – using the \&quot;Tetanus toxoid-containing vaccine (TTCV) immunization – WITH PREVIOUS\&quot; schedule (1 dose scheme))</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>
    </Library>
  </contained>
  <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/ANCDT32"/>
  <identifier>
    <use value="official"/>
    <value value="ANC.DT.32"/>
  </identifier>
  <version value="0.3.0"/>
  <name value="ANCDT32"/>
  <title value="ANC.DT.32 Tetanus toxoid-containing vaccination"/>
  <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="If the woman has not yet been fully immunized against tetanus, she should be immunized			"/>
  <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.B10.7."/>
        <display value="Immunizations"/>
      </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/ANCDT32"/>
  <action>
    <title value="ANC.DT.32 Tetanus toxoid-containing vaccination"/>
    <trigger>
      <type value="named-event"/>
      <name value="ANC.B10.7. Immunizations"/>
    </trigger>
    <action id="1">
      <title
             value="Provide tetanus toxoid immunizations – using the &quot;Tetanus toxoid-containing vaccine (TTCV) immunization – NO PREVIOUS&quot; schedule (3 dose scheme)"/>
      <description
                   value="Provide tetanus toxoid immunizations – using the &quot;Tetanus toxoid-containing vaccine (TTCV) immunization – NO PREVIOUS&quot; schedule (3 dose scheme)"/>
      <textEquivalent
                      value="Tetanus toxoid (TT) vaccination is recommended for all pregnant women who are not fully immunised against TT to prevent neonatal mortality from tetanus"/>
      <documentation>
        <type value="citation"/>
        <label
               value="WHO ANC recommendations (2016): C.5. Tetanus toxoid vaccination (3)

Maternal immunization against tetanus (IMPAC) (2006) (11)"/>
      </documentation>
      <condition>
        <kind value="applicability"/>
        <expression>
          <description
                       value="((&quot;Tetanus toxoid-containing vaccine (TTCV) immunization history&quot; = &quot;Under-immunized&quot;)
  OR (&quot;Tetanus toxoid-containing vaccine (TTCV) immunization history&quot; = &quot;No doses&quot;))
  OR (&quot;Tetanus toxoid-containing vaccine (TTCV) immunization history&quot; = &quot;Unknown&quot;)"/>
          <language value="text/cql-identifier"/>
          <expression
                      value="Should Provide tetanus toxoid immunizations – using the \&quot;Tetanus toxoid-containing vaccine (TTCV) immunization – NO PREVIOUS\&quot; schedule (3 dose scheme)"/>
        </expression>
      </condition>
    </action>
    <action id="2">
      <title
             value="Provide tetanus toxoid immunizations – using the &quot;Tetanus toxoid-containing vaccine (TTCV) immunization – WITH PREVIOUS&quot; schedule (1 dose scheme)"/>
      <description
                   value="Provide tetanus toxoid immunizations – using the &quot;Tetanus toxoid-containing vaccine (TTCV) immunization – WITH PREVIOUS&quot; schedule (1 dose scheme)"/>
      <textEquivalent
                      value="1–4 doses of TTCV in the past:
– 1 dose scheme: Woman should receive one dose of TTCV during each subsequent pregnancy to a total of five doses (five doses protects throughout the childbearing years)"/>
      <documentation>
        <type value="citation"/>
        <label
               value="WHO ANC recommendations (2016): C.5. Tetanus toxoid vaccination (3)

Maternal immunization against tetanus (IMPAC) (2006) (11)"/>
      </documentation>
      <condition>
        <kind value="applicability"/>
        <expression>
          <description
                       value="((((&quot;Tetanus toxoid-containing vaccine (TTCV) 1 immunization provided&quot; = TRUE)
  AND (&quot;Tetanus toxoid-containing vaccine (TTCV) 2 immunization provided&quot; = TRUE)
  AND (&quot;Tetanus toxoid-containing vaccine (TTCV) 3 immunization provided&quot; = TRUE)
  AND (&quot;Tetanus toxoid-containing vaccine (TTCV) 4 immunization provided&quot; =  TRUE))
  OR ((&quot;Tetanus toxoid-containing vaccine (TTCV) 1 immunization provided&quot; = TRUE)
  AND (&quot;Tetanus toxoid-containing vaccine (TTCV) 2 immunization provided&quot; = TRUE)
  AND (&quot;Tetanus toxoid-containing vaccine (TTCV) 3 immunization provided&quot; = TRUE)))
  OR ((&quot;Tetanus toxoid-containing vaccine (TTCV) 1 immunization provided&quot; = TRUE)
  AND (&quot;Tetanus toxoid-containing vaccine (TTCV) 2 immunization provided&quot; = TRUE)))
  OR (&quot;Tetanus toxoid-containing vaccine (TTCV) 1 immunization provided&quot; = TRUE)"/>
          <language value="text/cql-identifier"/>
          <expression
                      value="Should Provide tetanus toxoid immunizations – using the \&quot;Tetanus toxoid-containing vaccine (TTCV) immunization – WITH PREVIOUS\&quot; schedule (1 dose scheme)"/>
        </expression>
      </condition>
    </action>
  </action>
</PlanDefinition>