/**
* 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
// 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":
true
/**
* 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":
true
/* end Populations */
|