Title: HIV.IND.41 Logic Id: HIVIND41Logic Version: 0.4.4 Url: HIV.IND.41 Logic Status: draft Experimental: true Type: system: http://terminology.hl7.org/CodeSystem/library-type code: logic-library Date: 2025-12-08 16:41:10+0000 Publisher: WHO Description: % of HIV-exposed breastfeeding infants whose mothers are receiving ART at 12 (and 24 months) postpartum 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 Age Stratifier string 0 1 Out Timing of ART initiation Coding 0 1 Out Geographic Region Stratifier string 0 1 Out Stratification string 0 1 Out Content: text/cql /** * Library: HIV.IND.41 Logic * Ref No: VER.5 * Short Name: ART coverage in breastfeeding mothers * * Definition: % of HIV-exposed breastfeeding infants whose mothers are receiving ART at 12 (and 24 months) postpartum * * Numerator: Number of HIV-exposed breastfeeding infants whose mothers are receiving ART at 12 months (and 24 months*) postpartum * Numerator Calculation: COUNT of infants who are an "HIV-exposed infant or child" AND whose mothers are "Breastfeeding" 12 months after "Delivery date" AND mothers with "On ART"=True 12 months after "Delivery date" | | Also reported for 24 months after "Delivery date" * Numerator Exclusions: * * Denominator: Number of HIV-exposed infants attending MNCH services for a 12-month visit (and 24-month visit or first visit after the end of breastfeeding) * Denominator Calculation: COUNT of infants who are an "HIV-exposed infant or child" AND [(whose mothers attend a 12-month "Maternal and child health service visit") OR (first "Maternal and child health service visit" after "Delivery date" where mother is NOT "Breastfeeding")] | | Also reported for mothers attending 24-month "Maternal and child health service visit" * Denominator Exclusions: * * Disaggregations: * • Age (<15, 15–19, 20–24, 25+ years) * • Timing of ART initiation (already on ART at first ANC visit, newly on ART during pregnancy or labour and delivery) * • Cities and other administrative regions of epidemiologic importance * * Disaggregation Elements: Age | Timing of ART initiation | Breastfeeding at 24 months * * Numerator and Denominator Elements: * Breastfeeding * Delivery date * HIV-exposed infant or child * Maternal and child health service visit * On ART * * Reference: Consolidated guidelines on person-centred HIV strategic information: strengthening routine data for impact. Geneva: World Health Organization; 2022 * * Data Concepts: * HIV.A.DE17: Age | Calculated age (number of years) of the client based on date of birth * HIV.B.DE32: Breastfeeding | Infant is being breastfed by mother * HIV.D.DE32: Breastfeeding | Client is giving infant breast milk * 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.DE112: HIV-exposed infant or child | Whether the infant or child was determined to have had HIV exposure * HIV.E.DE173: Maternal and child health service visit | Maternal and child health service visit attended by an HIV-exposed infant * HIV.E.DE174: 12-month visit | HIV-exposed infant attending MCH services for a 12-month visit * HIV.E.DE175: 24-month visit | HIV-exposed infants attending MCH services for a 24-month visit * HIV.E.DE176: First visit after the end of breastfeeding | HIV-exposed infant attending MCH services for a first visit after the end of breastfeeding * HIV.H.DE47: On ART | Client is currently taking ART * HIV.SRV.DE20: HIV-exposed infant or child | Whether the infant or child was determined to have had HIV exposure * * Additional Context * - what it measures: This indicator measures the programme's ability to reduce the risk of transmission via breastfeeding (Prong 3 of the PMTCT strategy). * - rationale: • In many countries the average breastfeeding period is 18–24 months. The long breastfeeding period represents an important risk period for HIV-exposed infants. | • Ensuring that HIV-positive mothers are retained on ART, especially during the breastfeeding period, is critical to sustaining the health of the mother and preventing infection of her infant. * - method: For the numerator: Programme records (for example, PMTCT registers, ART registers). | | For the denominator: Programme records (for example, MCH service records) * * Suggested Scoring Method: proportion | http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm */ library HIVIND41Logic // 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-exposed breastfeeding infants whose mothers are receiving ART at 12 months (and 24 months*) postpartum * Calculation: COUNT of infants who are an "HIV-exposed infant or child" AND whose mothers are "Breastfeeding" 12 months after "Delivery date" AND mothers with "On ART"=True 12 months after "Delivery date" | | Also reported for 24 months after "Delivery date" */ define "Numerator": HIE."is HIV-exposed infant or child E.DE112" and exists(HIE."Breastfeeding B.DE32" B where months between end of B.effective.toInterval() and end of Last(HIE."Live Birth Delivery" B where B.effective.toInterval() before "Measurement Period").effective.toInterval() > 12 months ) and exists ( HE."On ART D.DE38" A where months between end of A.effective.toInterval() and end of Last(HIE."Live Birth Delivery" B where B.effective.toInterval() before "Measurement Period").effective.toInterval() > 12 months ) /** * Denominator * * Definition: Number of HIV-exposed infants attending MNCH services for a 12-month visit (and 24-month visit or first visit after the end of breastfeeding) * Calculation: COUNT of infants who are an "HIV-exposed infant or child" AND [(whose mothers attend a 12-month "Maternal and child health service visit") OR (first "Maternal and child health service visit" after "Delivery date" where mother is NOT "Breastfeeding")] | | Also reported for mothers attending 24-month "Maternal and child health service visit" */ define "Denominator": HIE."is HIV-exposed infant or child E.DE112" and (HIE."12-month visit" or exists(HE."Not Breastfeeding B.DE32" B with HE."Maternal and child health service visit" E such that B.encounter.references(E) and E.period.toInterval() after end of Last(HIE."Live Birth Delivery" B where B.effective.toInterval() before "Measurement Period").effective.toInterval()) ) /* end Populations */ /* * Disaggregators */ define "Age Stratifier": HIE."By Age Stratifier 10" define "Timing of ART initiation": HIE."Timing of ART initiation" define "Geographic Region Stratifier": HIE."By Geographic Region Stratifier" define "Stratification": HIE."By Age Stratifier 10" + ':' + HIE."By Geographic Region Stratifier" + HIE."Timing of ART initiation".code Content: application/elm+xml Encoded data (96040 characters) Content: application/elm+json Encoded data (187172 characters)
% of HIV-exposed breastfeeding infants whose mothers are receiving ART at 12 (and 24 months) postpartum