| Code | Display | Definition |
| not-applicable |
Not Applicable |
Used when a concept does not apply in the current clinical context. |
| muac-green |
Green — Normal (≥23 cm) |
MUAC measurement indicating normal nutritional status (≥23 cm). |
| muac-yellow |
Yellow — Moderate Acute Malnutrition (20–22.9 cm) |
MUAC measurement indicating moderate acute malnutrition (20–22.9 cm). |
| muac-red |
Red — Severe Acute Malnutrition (<20 cm) |
MUAC measurement indicating severe acute malnutrition (<20 cm). |
| breast-normal |
Yes — Normal |
Breast examination result: normal findings. |
| breast-abnormal |
Yes — Abnormal |
Breast examination result: abnormal findings. |
| not-done |
Not Done |
The procedure or test was not performed. |
| fgm-scarring |
Scarring |
FGM complication: scarring. |
| fgm-keloid |
Keloid formation |
FGM complication: keloid formation. |
| fgm-dyspareunia |
Dyspareunia |
FGM complication: dyspareunia (painful intercourse). |
| fgm-uti |
Urinary tract infection |
FGM complication: urinary tract infection. |
| rbs-normal |
RBS < 11.1 mmol/L — No Diabetes |
Random blood sugar below 11.1 mmol/L; no diabetes indicated. |
| rbs-diabetes |
RBS ≥ 11.1 mmol/L — Has Diabetes |
Random blood sugar at or above 11.1 mmol/L; diabetes indicated. |
| rbs-not-done |
No RBS Done |
Random blood sugar test was not performed. |
| rpr |
RPR (Rapid Plasma Reagin) |
Syphilis test: Rapid Plasma Reagin. |
| vdrl |
VDRL (Venereal Disease Research Laboratory) |
Syphilis test: Venereal Disease Research Laboratory. |
| dual-testing |
Dual Testing (RPR + VDRL) |
Syphilis test: combined RPR and VDRL testing. |
| presumed-tb |
Presumed TB |
Clinically or radiologically suspected TB, not yet confirmed. |
| no-tb-signs |
No Signs of TB |
No clinical signs of tuberculosis detected. |
| on-tb-treatment |
Already on TB Treatment |
Patient is already receiving TB treatment. |
| hiv-known-positive |
Known Positive — Status before 1st ANC (KP) |
HIV-positive status known prior to the first ANC visit. |
| hiv-initial-test |
Initial Test (I) |
First HIV test performed at this visit. |
| hiv-retest |
Retest (R) |
HIV retest performed at this visit. |
| hiv-previously-positive |
Previously Positive (PrevP) |
Patient was previously known to be HIV-positive. |
| hiv-previously-negative |
Previously Negative (PrevN) |
Patient was previously known to be HIV-negative. |
| arv-yes |
Yes — On ARV/HAART |
Patient is currently on antiretroviral or HAART therapy. |
| arv-no |
No — Not on ARV/HAART |
Patient is not on antiretroviral or HAART therapy. |
| arv-revisit |
Revisit (already on treatment) |
Patient is revisiting and is already on ARV/HAART treatment. |
| partner-tested |
Yes — Partner Tested |
The patient's partner has been tested for HIV. |
| partner-not-tested |
No — Partner Not Tested |
The patient's partner has not been tested for HIV. |
| partner-not-present |
Not Applicable (Partner Not Present) |
Partner was not present; HIV testing status not applicable. |
| partner-known-positive |
Known Positive (KP) |
Partner is known to be HIV-positive. |
| fp-iud |
IUD (Intrauterine Device) |
Family planning method: intrauterine device. |
| fp-implants |
Implants (Subdermal) |
Family planning method: subdermal implants. |
| fp-btl |
BTL (Bilateral Tubal Ligation) |
Family planning method: bilateral tubal ligation. |
| fp-counselled-no-method |
Counselled — No Method Selected |
Patient was counselled on family planning but did not select a method. |
| fp-cocp |
Combined oral contraceptive pills |
Family planning method: combined oral contraceptive pills. |
| fp-pop |
Progestin only contraceptive pills |
Family planning method: progestin-only contraceptive pills. |
| fp-injectables |
Injectables |
Family planning method: injectable contraceptives. |
| fp-male-condom |
Male condom |
Family planning method: male condom. |
| fp-female-sterilization |
Female sterilization |
Family planning method: female sterilization. |
| fp-vasectomy |
Vasectomy |
Family planning method: vasectomy. |
| fp-fam |
Fertility awareness-based methods |
Family planning method: fertility awareness-based methods. |
| fp-ec |
Emergency contraception |
Family planning method: emergency contraception. |
| anc-hypertension |
Hypertension |
ANC comorbidity: hypertension. |
| anc-diabetes |
Diabetes Mellitus |
ANC comorbidity: diabetes mellitus. |
| anc-epilepsy |
Epilepsy |
ANC comorbidity: epilepsy. |
| anc-malaria |
Malaria in Pregnancy |
ANC comorbidity: malaria in pregnancy. |
| anc-sti-rti |
STIs / RTIs |
ANC comorbidity: sexually or reproductively transmitted infections. |
| anc-other |
Other (Specify) |
ANC comorbidity: other, to be specified. |
| ipt-dose-1 |
IPT Dose 1 (SP) |
Intermittent Preventive Treatment dose 1 (Sulfadoxine-Pyrimethamine). |
| ipt-dose-2 |
IPT Dose 2 (SP) |
Intermittent Preventive Treatment dose 2 (Sulfadoxine-Pyrimethamine). |
| ipt-dose-3 |
IPT Dose 3 (SP) |
Intermittent Preventive Treatment dose 3 (Sulfadoxine-Pyrimethamine). |
| tt-dose-1 |
TT Dose 1 |
Tetanus toxoid dose 1. |
| tt-dose-2 |
TT Dose 2 |
Tetanus toxoid dose 2. |
| tt-dose-3 |
TT Dose 3 |
Tetanus toxoid dose 3. |
| tt-dose-4 |
TT Dose 4 |
Tetanus toxoid dose 4. |
| tt-dose-5 |
TT Dose 5 |
Tetanus toxoid dose 5. |
| tt-none |
None / Not Applicable |
No tetanus toxoid dose administered; not applicable. |
| supp-ifa |
Combined Iron and Folic Acid (IFA) |
Supplementation: combined iron and folic acid. |
| supp-iron-only |
Iron Supplement Only |
Supplementation: iron only. |
| supp-folate-only |
Folate Supplement Only |
Supplementation: folate only. |
| supp-iron-folate-sep |
Iron + Folate (Separately) |
Supplementation: iron and folate given as separate supplements. |
| supp-calcium |
Calcium Supplement |
Supplementation: calcium. |
| referral-community-unit |
Community Unit |
Referral source or destination: community health unit. |
| referral-another-facility |
Another Health Facility |
Referral source or destination: another health facility. |
| delivery-facility |
Facility |
Baby delivered in a health facility. |
| delivery-home |
Home |
Baby delivered at home. |
| delivery-bba |
BBA (Born Before Arrival) |
Baby born before arrival at a health facility. |
| delivery-svd |
SVD (Spontaneous Vaginal Delivery) |
Spontaneous vaginal delivery. |
| delivery-cs |
CS (Caesarean Section) |
Caesarean section delivery. |
| delivery-breech |
Breech |
Breech delivery. |
| delivery-avd |
AVD (Assisted Vaginal Delivery) |
Assisted vaginal delivery. |
| pnc-0-48h |
0–48 hours postpartum |
PNC visit occurring within 48 hours of delivery. |
| pnc-3d-6w |
3 days to 6 weeks postpartum |
PNC visit occurring between 3 days and 6 weeks after delivery. |
| pnc-gt-6w |
More than 6 weeks postpartum |
PNC visit occurring more than 6 weeks after delivery. |
| pallor-mild |
Mild |
Mild pallor. |
| pallor-moderate |
Moderate |
Moderate pallor. |
| pallor-severe |
Severe |
Severe pallor. |
| pallor-absent |
Absent |
No pallor detected. |
| breast-state-normal |
Normal |
Breast state: normal. |
| breast-cracked-nipple |
Cracked nipple |
Breast state: cracked nipple. |
| breast-engorged |
Engorged |
Breast state: breast engorgement. |
| breast-mastitis |
Mastitis |
Breast state: mastitis. |
| uterus-contracted |
Contracted |
Uterus is contracted. |
| uterus-not-contracted |
Not contracted |
Uterus is not contracted. |
| uterus-other |
Other (specify) |
Uterus state: other, to be specified. |
| pph-present |
Present |
Postpartum haemorrhage is present. |
| pph-absent |
Absent |
Postpartum haemorrhage is absent. |
| cs-site-bleeding |
Bleeding |
C-section site state: bleeding. |
| cs-site-normal |
Normal |
C-section site state: normal. |
| cs-site-infected |
Infected |
C-section site state: infected. |
| cs-site-gaping |
Gaping |
C-section site state: gaping. |
| lochia-normal |
Normal |
Lochia state: normal. |
| lochia-foul-smelling |
Foul smelling |
Lochia state: foul smelling. |
| lochia-excessive |
Excessive |
Lochia state: excessive. |
| episiotomy-repaired |
Repaired |
Episiotomy state: repaired. |
| episiotomy-gaping |
Gaping |
Episiotomy state: gaping. |
| episiotomy-infected |
Infected |
Episiotomy state: infected. |
| episiotomy-healed |
Healed |
Episiotomy state: healed. |
| cx-normal |
Normal (1) |
Cervical cancer screening result: normal. |
| cx-suspected |
Suspected (2) |
Cervical cancer screening result: suspected. |
| cx-confirmed |
Confirmed (3) |
Cervical cancer screening result: confirmed. |
| cx-not-done |
Not Done (4) |
Cervical cancer screening was not performed. |
| wfa-normal |
Normal (1) |
Weight-for-age: normal. |
| wfa-underweight |
Underweight (2) |
Weight-for-age: underweight. |
| wfa-severe-underweight |
Severe Underweight (3) |
Weight-for-age: severe underweight. |
| wfa-overweight |
Overweight (4) |
Weight-for-age: overweight. |
| wfa-obese |
Obese (5) |
Weight-for-age: obese. |
| hfa-normal |
Normal (1) |
Height/length-for-age: normal. |
| hfa-stunted |
Stunted (2) |
Height/length-for-age: stunted. |
| hfa-severely-stunted |
Severely Stunted (3) |
Height/length-for-age: severely stunted. |
| vita-6-11m |
Supplemented — 6 to 11 months (1) |
Vitamin A supplementation given to a child aged 6–11 months. |
| vita-12-59m |
Supplemented — 12 to 59 months (2) |
Vitamin A supplementation given to a child aged 12–59 months. |
| vita-not-supplemented |
Not supplemented (3) |
Vitamin A supplementation not given. |
| milestone-head-control |
Head control (1) |
Developmental milestone: head control. |
| milestone-sitting |
Sitting (2) |
Developmental milestone: sitting. |
| milestone-talking |
Talking (3) |
Developmental milestone: talking. |
| cwc-danger-no-breastfeed |
Unable to breastfeed (1) |
CWC danger sign: child is unable to breastfeed. |
| cwc-danger-no-drink |
Unable to drink (2) |
CWC danger sign: child is unable to drink. |
| cwc-danger-vomits-all |
Vomits everything (3) |
CWC danger sign: child vomits everything. |
| cwc-danger-bloody-diarrhoea |
Bloody diarrhoea (4) |
CWC danger sign: bloody diarrhoea. |
| cwc-danger-oedema |
Oedema (5) |
CWC danger sign: oedema. |
| cwc-danger-convulsions |
Convulsions (6) |
CWC danger sign: convulsions. |
| disability-present |
Disability / Congenital deformity present (1) |
A disability or congenital deformity is present. |
| cwc-followup-nutrition |
Nutrition services (1) |
CWC follow-up: nutrition services. |
| cwc-followup-rehabilitation |
Rehabilitation services (2) |
CWC follow-up: rehabilitation services. |
| cx-visit-initial-screening |
Initial screening |
Cervical cancer visit type: initial screening. |
| cx-visit-routine-screening |
Routine screening |
Cervical cancer visit type: routine screening. |
| cx-visit-treatment |
Treatment visit |
Cervical cancer visit type: treatment visit. |
| cx-visit-post-treatment |
Post-treatment visit |
Cervical cancer visit type: post-treatment visit. |
| cx-visit-post-treatment-complications |
Post-treatment complications |
Cervical cancer visit type: post-treatment complications. |
| via-positive |
Positive |
VIA/VILI/HPV test result: positive. |
| via-negative |
Negative |
VIA/VILI/HPV test result: negative. |
| via-suspicious-cancer |
Suspicious for cancer |
VIA/VILI/HPV test result: suspicious for cancer. |
| pap-normal |
Normal |
Pap smear result: normal. |
| pap-ascus |
ASCUS/ASC-H (Atypical squamous cells of undetermined significance, high grade lesion not excluded) |
Pap smear result: ASCUS/ASC-H. |
| pap-lsil |
LSIL (Low grade squamous intraepithelial lesion) |
Pap smear result: LSIL. |
| pap-hsil |
HSIL/CIS (High grade squamous intraepithelial lesion) |
Pap smear result: HSIL/CIS. |
| pap-agus |
AGUS (Atypical glandular cells of undetermined significance) |
Pap smear result: AGUS. |
| pap-invasive-cancer |
Invasive cancer |
Pap smear result: invasive cancer. |
| pap-other |
Other, please specify |
Pap smear result: other, to be specified. |
| colpo-satisfactory |
Satisfactory |
Colposcopy/cervicography result: satisfactory. |
| colpo-unsatisfactory |
Unsatisfactory |
Colposcopy/cervicography result: unsatisfactory. |
| colpo-normal |
Normal |
Colposcopy/cervicography result: normal. |
| colpo-acetowhite |
Acetowhite |
Colposcopy/cervicography result: acetowhite. |
| colpo-leukoplakia |
Leukoplakia |
Colposcopy/cervicography result: leukoplakia. |
| colpo-punctuation |
Punctuation |
Colposcopy/cervicography result: punctuation. |
| colpo-abnormal-vessels |
Abnormal vessels |
Colposcopy/cervicography result: abnormal vessels. |
| colpo-mosaicism |
Mosaicism |
Colposcopy/cervicography result: mosaicism. |
| cx-activity-screening-cryo-done |
Screening today, with cryotherapy done today |
Cervical cancer activity: screening and cryotherapy both performed today. |
| cx-activity-screening-cryo-postponed |
Screening done today, with cryotherapy postponed |
Cervical cancer activity: screening done today, cryotherapy postponed. |
| cx-activity-treated-postponed-case |
Treated a previously screened and postponed case |
Cervical cancer activity: treated a previously screened and postponed case. |
| chronic-dm |
Diabetes mellitus (DM) |
Chronic care follow-up condition: diabetes mellitus. |
| chronic-htn |
Hypertension (HTN) |
Chronic care follow-up condition: hypertension. |
| chronic-dm-htn |
Both DM and HTN |
Chronic care follow-up condition: both diabetes mellitus and hypertension. |
| chronic-asthma |
Asthma |
Chronic care follow-up condition: asthma. |
| chronic-arthritis |
Arthritis |
Chronic care follow-up condition: arthritis. |
| chronic-other |
Other |
Chronic care follow-up condition: other. |
| scale-0-none |
0 = None / Best possible |
0–10 labelled scale: 0 = none / best possible. |
| scale-1-3-mild |
1–3 = Mild / Manageable |
0–10 labelled scale: 1–3 = mild / manageable. |
| scale-4-6-moderate |
4–6 = Moderate (affects daily activities) |
0–10 labelled scale: 4–6 = moderate, affects daily activities. |
| scale-7-9-severe |
7–9 = Severe |
0–10 labelled scale: 7–9 = severe. |
| scale-10-worst |
10 = Worst / Completely limited |
0–10 labelled scale: 10 = worst / completely limited. |
| pain-0-none |
0 = No pain |
Pain scale: 0 = no pain. |
| pain-1-3-mild |
1–3 = Mild pain (annoying but manageable) |
Pain scale: 1–3 = mild pain, annoying but manageable. |
| pain-4-6-moderate |
4–6 = Moderate pain (affects daily activities) |
Pain scale: 4–6 = moderate pain, affects daily activities. |
| pain-10-worst |
10 = Worst pain |
Pain scale: 10 = worst pain. |
| eye-swelling |
Eye swelling |
Eye complication: eye swelling. |
| eye-impaired-vision |
Impaired vision |
Eye complication: impaired vision. |
| eye-double-vision |
Double vision |
Eye complication: double vision. |
| renal-urine-volume |
Volume of urine |
Renal complication: abnormal volume of urine. |
| renal-facial-oedema |
Facial oedema |
Renal complication: facial oedema. |
| renal-pedal-oedema |
Pedal oedema |
Renal complication: pedal oedema. |
| cardiac-chest-pain |
Chest pain |
Cardiac complication: chest pain. |
| cardiac-difficulty-breathing |
Difficulty in breathing |
Cardiac complication: difficulty in breathing. |
| cardiac-orthopnea |
Orthopnea |
Cardiac complication: orthopnea. |
| cardiac-pnd |
Paroxysmal nocturnal dyspnea |
Cardiac complication: paroxysmal nocturnal dyspnea. |
| msk-lower-limb-swelling |
Lower limb swelling |
Musculoskeletal complication: lower limb swelling. |
| msk-numbness |
Numbness |
Musculoskeletal complication: numbness. |
| msk-burning-sensation |
Burning sensation in hands and feet |
Musculoskeletal complication: burning sensation in hands and feet. |
| cns-headaches |
Headaches |
CNS complication: headaches. |
| cns-tia |
Transient ischaemic attacks |
CNS complication: transient ischaemic attacks. |
| phys-sleepy |
Sleepy |
Physical health symptom: sleepy. |
| phys-breathing-difficulties |
Breathing difficulties |
Physical health symptom: breathing difficulties. |
| phys-low-energy |
Low energy |
Physical health symptom: low energy. |
| phys-no-appetite |
No appetite |
Physical health symptom: no appetite. |
| phys-pain |
Pain |
Physical health symptom: pain. |
| emot-sad |
Sad |
Emotional health symptom: sad. |
| emot-stressed |
Stressed |
Emotional health symptom: stressed. |
| emot-anxiety |
Anxiety |
Emotional health symptom: anxiety. |
| emot-worry |
Worry |
Emotional health symptom: worry. |
| emot-mood-swings |
Mood swings |
Emotional health symptom: mood swings. |
| vvf |
VVF (Vesicovaginal fistula) |
Fistula type: vesicovaginal fistula. |
| rvf |
RVF (Rectovaginal fistula) |
Fistula type: rectovaginal fistula. |
| vvr |
VVR (Vesicovaginal Reflux) |
Fistula type: vesicovaginal reflux. |