Title: HIV.IND.40 Logic Id: HIVIND40Logic Version: 0.4.4 Url: HIV.IND.40 Logic Status: draft Experimental: true Type: system: http://terminology.hl7.org/CodeSystem/library-type code: logic-library Date: 2025-12-10 09:22:27+0000 Publisher: WHO Description: % of HIV-positive pregnant women who received ART during pregnancy and/or at labour and delivery Related Artifacts: Dependencies http://smart.who.int/hiv/Library/HIVCommon|0.0.1 WHOCommon HIVElements HIVIndicatorElements Parameters: Name Type Min Max In/Out Measurement Period Period 0 1 In Patient Patient 0 1 Out Initial Population boolean 0 1 Out Numerator boolean 0 1 Out Denominator boolean 0 1 Out Timing of ART initiation Coding 0 1 Out Stratification string 0 1 Out Content: text/cql /** * Library: HIV.IND.40 Logic * Ref No: VER.4 * Short Name: ART coverage in pregnant women * * Definition: % of HIV-positive pregnant women who received ART during pregnancy and/or at labour and delivery * * Numerator: Number of HIV-positive pregnant women who delivered during the reporting period and received ART during pregnancy and/or at labour and delivery * Numerator Calculation: COUNT of women with "HIV status"='HIV-positive' AND "Delivery date" in the reporting period AND (("On ART"=True at labour and delivery) OR ("On ART"=True during pregnancy, for this pregnancy)) * Numerator Exclusions: * * Denominator: a) Programme-based/service delivery denominator | Number of HIV-positive pregnant women who delivered during the reporting period and attended ANC or had a facility-based delivery | b) Population-based denominator | Number of HIV-positive pregnant women who delivered during the reporting period * Denominator Calculation: Programme-based/service delivery denominator: | COUNT of women with "HIV status"='HIV-positive' AND "Delivery date" in the reporting period AND (had an "ANC contact date" during reporting period OR "Place of delivery" was a 'Health facility') | | Population-based denominator: | *Number of HIV-positive pregnant women who delivered during the reporting period * Denominator Exclusions: * * Disaggregations: * Numerator: * • Timing of ART initiation (1. already on ART at first ANC visit, 2. newly on ART during pregnancy, 3. newly on ART during labour and delivery, 4. on non-recommended ART regimen) * * The primary indicator calculation should include ART status categories 1, 2 and 3. Removing the women in category 1 "already on ART at first ANC visit" from the numerator and denominator gives a measure of ART coverage among HIV-positive pregnant women newly diagnosed during ANC. Dividing category 2 by the sum of categories 2 and 3 gives the proportion of new ART initiations occurring during pregnancy rather than at delivery. Calculating the indicator with those in category 4 (non-recommended ARV regimen) included in the numerator gives a broader measure, that is, coverage of HIV-positive pregnant women receiving any ARV drug. * * Disaggregation Elements: Timing of ART initiation * * Numerator and Denominator Elements: * ANC contact date * Delivery date * HIV status * On ART * Place of delivery * * Reference: Consolidated guidelines on person-centred HIV strategic information: strengthening routine data for impact. Geneva: World Health Organization; 2022 * * Data Concepts: * HIV.B.DE115: HIV status | HIV status reported after applying the national HIV testing algorithm. No single HIV test can provide an HIV-positive diagnosis. * HIV.B.DE116: HIV-positive | Client is HIV-positive * HIV.B.DE117: HIV-negative | Client is HIV-negative * HIV.B.DE118: Unknown | Client has unknown HIV status * HIV.D.DE38: On ART | Client is currently taking ART * HIV.E.DE41: Timing of ART initiation | When the pregnant woman or mother initiated ART, for women living with HIV. * HIV.E.DE42: Already on ART at first antenatal care visit | The pregnant woman was already on antiretroviral therapy (ART) at first antenatal care visit * HIV.E.DE43: Newly on ART during pregnancy | The pregnant woman started ART during her pregnancy * HIV.E.DE44: Newly on ART during labour and delivery | The woman started ART during labour and delivery * HIV.E.DE46: Delivery date | Date on which the woman delivered * HIV.E.DE67: Place of delivery | The type of place where the woman delivered * HIV.E.DE68: Health facility | The woman delivered at a health facility * HIV.E.DE69: Home | The woman delivered at home * HIV.E.DE70: Other | The woman delivered at another location that is not at home or at a health facility * HIV.E.DE85: ANC contact date | The date and time of the client's ANC contact (in the ANC DAK this is called 'Contact date') * HIV.H.DE47: On ART | Client is currently taking ART * HIV.SRV.DE18: ANC contact date | The date and time of the client's ANC contact (in the ANC DAK this is called 'Contact date') * * Additional Context * - what it measures: This indicator measures whether a recommended course of ART has been provided to HIV-positive pregnant women. * - rationale: • Providing ART for HIV-positive pregnant women is a critical strategy for preventing vertical transmission of HIV. | • In an era of "Treat All", all HIV-positive pregnant women should be given a recommended regimen of ART as soon as possible after diagnosis, including during labour and delivery. * - method: a) For the numerator and programme-based/service delivery denominator: Programme records (for example, PMTCT registers, ARV registers, labour and delivery registers) | | b) For the population-based denominator: Modelling-based estimates (for example, Spectrum AIM) | | The recommended reporting period is 12 months. * * Suggested Scoring Method: proportion | http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm */ library HIVIND40Logic // Included Libraries using FHIR version '4.0.1' include HIVCommon version '0.0.1' called HIC include FHIRHelpers version '4.0.1' include WHOCommon called WCom include HIVElements called HE include HIVIndicatorElements called HIE // Indicator Definition parameter "Measurement Period" Interval<Date> default Interval[@2023-01-01, @2023-01-30] context Patient /* Populations */ /* *Initial Population */ define "Initial Population": true /** * Numerator * * Definition: Number of HIV-positive pregnant women who delivered during the reporting period and received ART during pregnancy and/or at labour and delivery * Calculation: COUNT of women with "HIV status"='HIV-positive' AND "Delivery date" in the reporting period AND (("On ART"=True at labour and delivery) OR ("On ART"=True during pregnancy, for this pregnancy)) */ define "Numerator": HIE."Has HIV-positive Status" and exists(HIE."Live Birth Delivery" BirthDelivery where BirthDelivery.effective.toInterval() during "Measurement Period" ) and exists ( HE."On ART D.DE38" A where A.effective.toInterval() during First(HIE."Live Birth Delivery" BirthDelivery where BirthDelivery.effective.toInterval() during "Measurement Period").effective.toInterval() or A.effective.toInterval() during First(HE."Currently pregnant B.DE29" C where C.prevalenceInterval() during "Measurement Period").prevalenceInterval() ) /** * Denominator * * Definition: a) Programme-based/service delivery denominator | Number of HIV-positive pregnant women who delivered during the reporting period and attended ANC or had a facility-based delivery | b) Population-based denominator | Number of HIV-positive pregnant women who delivered during the reporting period * Calculation: Programme-based/service delivery denominator: | COUNT of women with "HIV status"='HIV-positive' AND "Delivery date" in the reporting period AND (had an "ANC contact date" during reporting period OR "Place of delivery" was a 'Health facility') | | Population-based denominator: | *Number of HIV-positive pregnant women who delivered during the reporting period */ define "Denominator": HIE."Has HIV-positive Status" and exists(HIE."Live Birth Delivery" BirthDelivery where BirthDelivery.effective.toInterval() during "Measurement Period" )and (First(HIE."ANC within pregnancy").period.toInterval() during "Measurement Period" or HIE."Has Delivery in Health Facility") /* end Populations */ /* * Disaggregators */ define "Timing of ART initiation": HIE."Timing of ART initiation" define "Stratification": HIE."Timing of ART initiation".code Content: application/elm+xml Encoded data (65808 characters) Content: application/elm+json Encoded data (118552 characters)
% of HIV-positive pregnant women who received ART during pregnancy and/or at labour and delivery