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="ANCDT38"/>
<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;">ANCDT38</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-ANCDT38.html">ANC.DT.38 Deworming and malaria prophylaxis</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.38</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">ANC.DT.38 Deworming and malaria prophylaxis</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 is currently in a malaria-endemic setting, or in an area where there is greater than 20% prevalence of infection with any soil-transmitted helminths, THEN she should receive preventative treatment accordingly</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-ANCDT38.html">ANC.DT.38 Deworming and malaria prophylaxis</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.38 Deworming and malaria prophylaxis:</b>
<br/>
<b>When:</b>
<i>Named Event:</i> ANC.B10. Counselling, in-facility management and treatment
<br/>
<b>Then:</b>
<table class="grid-dict">
<tr>
<td>
Sleeping under an insecticide-treated bednet and the importance of seeking care and getting treatment as soon as she has any symptoms
<br/>
<b>If:</b>
<i>Applicability:</i>
Malaria-endemic setting = TRUE
<i>(Should Provide malaria prophylaxis)</i>
<br/>
</td>
</tr>
<tr>
<td>
IF the woman is currently taking co-trimoxazole, even in a malaria-endemic setting, she should not receive any dose of IPTp-SP. Women who are taking co-trimoxazole SHOULD NOT receive IPTp-SP. Taking both co-trimoxazole and IPTp-SP together can enhance side-effects, especially haematological side-effects such as anaemia.
<br/>
<b>If:</b>
<i>Applicability:</i>
(Malaria-endemic setting = TRUE)
AND (Current medications" = "Co-trimoxazole")
<i>(Should Do not give IPTp-SP, because woman is taking co-trimoxazole)</i>
<br/>
</td>
</tr>
<tr>
<td>
In areas with a population prevalence of infection with any soil-transmitted helminths of 20% or higher OR a population anaemia prevalence 40% or higher, preventive anthelminthic treatment is recommended for pregnant women after the first trimester as part of worm infection reduction programmes
<br/>
<b>If:</b>
<i>Applicability:</i>
("Population prevalence of soil-transmitted helminth infection" ≥ 20% )
OR ("Population prevalence of anaemia" ≥ 40%)
<i>(Should Conduct deworming)</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 Current medications"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b6-de109"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Current Medications - Co-trimoxazole Choices"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b6-de125"/>
</relatedArtifact>
<parameter>
<name value="encounter"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
</parameter>
<parameter>
<name
value="Should Do not give IPTp-SP, because woman is taking co-trimoxazole"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Should Provide malaria prophylaxis"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Should Conduct deworming"/>
<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-b6-de109"/>
</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="Malaria-endemic setting"/>
</extension>
<extension url="statement">
<valueString
value="/*
Description: Whether the setting is a malaria-endemic setting
*/
define "Malaria-endemic setting":
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="Current medications"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement: ANC.B6.DE109 Current medications
@activity: ANC.B6 Profile
@description: Select all of the medications the woman is currently taking
*/
define "Current medications":
[Observation: Cx."Current medications"] 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="ANCDT38"/>
</extension>
<extension url="name">
<valueString
value="Should Do not give IPTp-SP, because woman is taking co-trimoxazole"/>
</extension>
<extension url="statement">
<valueString
value="/*
(Malaria-endemic setting = TRUE)
AND (Current medications" = "Co-trimoxazole")
*/
define "Should Do not give IPTp-SP, because woman is taking co-trimoxazole":
Config."Malaria-endemic setting" = true
and ContactData."Current medications" in Cx."Current Medications - Co-trimoxazole Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT38"/>
</extension>
<extension url="name">
<valueString value="Should Provide malaria prophylaxis"/>
</extension>
<extension url="statement">
<valueString
value="/*
Malaria-endemic setting = TRUE
*/
define "Should Provide malaria prophylaxis":
Config."Malaria-endemic setting" = true"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</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 soil-transmitted helminth infection"/>
</extension>
<extension url="statement">
<valueString
value="/*
Description: The percentage of individuals in the general population
infected with at least one species of soil-transmitted helminth
*/
define "Population prevalence of soil-transmitted helminth infection":
21 '%'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</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 anaemia"/>
</extension>
<extension url="statement">
<valueString
value="/*
Description: The proportion of pregnant women in the population
with anaemia (haemoglobin level less than 11 g/dl)
*/
define "Population prevalence of anaemia":
41 '%'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT38"/>
</extension>
<extension url="name">
<valueString value="Should Conduct deworming"/>
</extension>
<extension url="statement">
<valueString
value="/*
("Population prevalence of soil-transmitted helminth infection" ≥ 20% )
OR ("Population prevalence of anaemia" ≥ 40%)
*/
define "Should Conduct deworming":
Config."Population prevalence of soil-transmitted helminth infection" >= 20 '%'
or Config."Population prevalence of anaemia" >= 40 '%'"/>
</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="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value ObservationStatus): value.value"/>
</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="ToBoolean"/>
</extension>
<extension url="statement">
<valueString
value="define function ToBoolean(value boolean): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</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="9"/>
</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="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 uri): 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="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value string): 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="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="13"/>
</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="14"/>
</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/ANCDT38"/>
<identifier>
<use value="official"/>
<value value="ANC.DT.38"/>
</identifier>
<version value="0.3.0"/>
<name value="ANCDT38"/>
<title value="ANC.DT.38 Deworming and malaria prophylaxis"/>
<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 is currently in a malaria-endemic setting, or in an area where there is greater than 20% prevalence of infection with any soil-transmitted helminths, THEN she should receive preventative treatment accordingly"/>
<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."/>
<display value="Counselling, in-facility management & treatment"/>
</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/ANCDT38"/>
<action>
<title value="ANC.DT.38 Deworming and malaria prophylaxis"/>
<trigger>
<type value="named-event"/>
<name
value="ANC.B10. Counselling, in-facility management and treatment"/>
</trigger>
<action id="1">
<title value="Provide malaria prophylaxis"/>
<description value="Provide malaria prophylaxis"/>
<textEquivalent
value="Sleeping under an insecticide-treated bednet and the importance of seeking care and getting treatment as soon as she has any symptoms"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): C.6. Malaria prevention: intermittent preventive treatment in pregnancy (IPTp) (3)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description value="Malaria-endemic setting = TRUE"/>
<language value="text/cql-identifier"/>
<expression value="Should Provide malaria prophylaxis"/>
</expression>
</condition>
</action>
<action id="2">
<title
value="Do not give IPTp-SP, because woman is taking co-trimoxazole"/>
<description
value="Do not give IPTp-SP, because woman is taking co-trimoxazole"/>
<textEquivalent
value="IF the woman is currently taking co-trimoxazole, even in a malaria-endemic setting, she should not receive any dose of IPTp-SP. Women who are taking co-trimoxazole SHOULD NOT receive IPTp-SP. Taking both co-trimoxazole and IPTp-SP together can enhance side-effects, especially haematological side-effects such as anaemia."/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): C.6. Malaria prevention: intermittent preventive treatment in pregnancy (IPTp) (3)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="(Malaria-endemic setting = TRUE)
AND (Current medications" = "Co-trimoxazole")"/>
<language value="text/cql-identifier"/>
<expression
value="Should Do not give IPTp-SP, because woman is taking co-trimoxazole"/>
</expression>
</condition>
</action>
<action id="3">
<title value="Conduct deworming"/>
<description value="Conduct deworming"/>
<textEquivalent
value="In areas with a population prevalence of infection with any soil-transmitted helminths of 20% or higher OR a population anaemia prevalence 40% or higher, preventive anthelminthic treatment is recommended for pregnant women after the first trimester as part of worm infection reduction programmes"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): C.4. Preventive anthelminthic treatment (3)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="("Population prevalence of soil-transmitted helminth infection" ≥ 20% )
OR ("Population prevalence of anaemia" ≥ 40%)"/>
<language value="text/cql-identifier"/>
<expression value="Should Conduct deworming"/>
</expression>
</condition>
</action>
</action>
</PlanDefinition>