HIV.E1CaptureOrUpdateMotherSHistory
type: Questionnaire
node role: treeRoot
id:
  v: HIV.E1CaptureOrUpdateMotherSHistory
meta:
  profile:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap
    l: sdc-questionnaire-extr-smap
  profile:
    v: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablequestionnaire
    l: crmi-shareablequestionnaire
  profile:
    v: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-publishablequestionnaire
    l: crmi-publishablequestionnaire
language:
  v: en
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: Questionnaire HIV.E1CaptureOrUpdateMotherSHistory Language: en Profiles: Extractable Questionnaire - StructureMap, CRMI Shareable Questionnaire, CRMI Publishable Questionnaire LinkID Text Cardinality Type Flags Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> Questionnaire for capture or update mother's history Questionnaire http://smart.who.int/hiv/Questionnaire/HIV.E1CaptureOrUpdateMotherSHistory#0.4.4 #xD; HIV.E.DE1 Pregnant woman's first name 0..1 string #xD; HIV.E.DE2 Pregnant woman's surname 0..1 string #xD; HIV.E.DE3 Pregnant woman's unique ID 0..1 string #xD; HIV.E.DE4 Antenatal care number 0..1 string #xD; HIV.E.DE5 Gestational age 1..1 integer #xD; HIV.E.DE6 Source of gestational age 1..1 choice Value Set: #HIV.E.DE6 #xD; HIV.E.DE10 Expected date of delivery (EDD) 1..1 date #xD; HIV.E.DE11 Number of pregnancies (gravida) 1..1 integer #xD; HIV.E.DE12 Number of previous pregnancies 1..1 integer #xD; HIV.E.DE13 Number of miscarriages and/or abortions 1..1 integer #xD; HIV.E.DE14 Number of live births 1..1 integer #xD; HIV.E.DE15 Number of caesarian sections 1..1 integer #xD; HIV.E.DE16 Number of stillbirths 1..1 integer #xD; HIV.E.DE17 Past pregnancy complications 0..1 choice Value Set: #HIV.E.DE17 #xD; HIV.E.DE35 Other past pregnancy problems (specify) 0..1 string #xD; HIV.E.DE36 Parity 1..1 integer #xD; HIV.E.DE37 Pregnancy in HIV-infected woman 0..1 boolean #xD; HIV.E.DE38 Date new pregnancy of HIV-positive woman identified 0..1 date #xD; HIV.E.DE39 ANC contact during pregnancy 0..1 boolean #xD; HIV.E.DE40 Date of first ANC visit 0..1 date #xD; HIV.E.DE41 Timing of ART initiation 0..1 choice Value Set: #HIV.E.DE41 #xD; HIV.E.DE45 Maternal use of recommended ART regimen 0..1 boolean #xD; HIV.E.DE46 Delivery date 1..1 date #xD; HIV.E.DE47 Pregnancy outcome 0..1 choice Value Set: #HIV.E.DE47 #xD; HIV.E.DE52 Delivery mode 0..1 choice Value Set: #HIV.E.DE52 #xD; HIV.E.DE56 Indications for caesarian…
url:
  v: http://smart.who.int/hiv/Questionnaire/HIV.E1CaptureOrUpdateMotherSHistory
  l: HIV.E1CaptureOrUpdateMotherSHistory
version:
  v: 0.4.4
title:
  v: Capture or update mother's history
status:
  v: draft
experimental:
  v: true
subject type:
  v: Patient
date:
  v: 2025-12-08T16:41:10+00:00
publisher:
  v: WHO
contact:
  name:
    v: WHO
  telecom:
    system:
      v: url
    value:
      v: http://who.int
description:
  v: Questionnaire for capture or update mother's history
item:
  id:
    v: HIV.E.DE1
  link id:
    v: HIV.E.DE1
  text:
    v: Pregnant woman's first name
  type:
    v: string
  required:
    v: false
  repeats:
    v: false
  read only:
    v: false
item:
  id:
    v: HIV.E.DE2
  link id:
    v: HIV.E.DE2
  text:
    v: Pregnant woman's surname
  type:
    v: string
  required:
    v: false
  repeats:
    v: false
  read only:
    v: false
item:
  id:
    v: HIV.E.DE3
  link id:
    v: HIV.E.DE3
  text:
    v: Pregnant woman's unique ID
  type:
    v: string
  required:
    v: false
  repeats:
    v: false
  read only:
    v: false
item:
  id:
    v: HIV.E.DE4
  link id:
    v: HIV.E.DE4
  text:
    v: Antenatal care number
  type:
    v: string
  required:
    v: false
  repeats:
    v: false
  read only:
    v: false
item:
  id:
    v: HIV.E.DE5
  link id:
    v: HIV.E.DE5
  text:
    v: Gestational age
  type:
    v: integer
  required:
    v: true
  repeats:
    v: false
  read only:
    v: false
item:
  id:
    v: HIV.E.DE6
  link id:
    v: HIV.E.DE6
  text:
    v: Source of gestational age
  type:
    v: choice
  required:
    v: true
  repeats:
    v: false
  read only:
    v: false
  answer value set:
    v: #HIV.E.DE6
    l: HIV.E.DE6
item:
  id:
    v: HIV.E.DE10
  link id:
    v: HIV.E.DE10
  text:
    v: Expected date of delivery (EDD)
  type:
    v: date
  required:
    v: true
  repeats:
    v: false
  read only:
    v: false
item:
  id:
    v: HIV.E.DE11
  link id:
    v: HIV.E.DE11
  text:
    v: Number of pregnancies (gravida)
  type:
    v: integer
  required:
    v: true
  repeats:
    v: false
  read only:
    v: false
item:
  id:
    v: HIV.E.DE12
  link id:
    v: HIV.E.DE12
  text:
    v: Number of previous pregnancies
  type:
    v: integer
  required:
    v: true
  repeats:
    v: false
  read only:
    v: false
item:
  id:
    v: HIV.E.DE13
  link id:
    v: HIV.E.DE13
  text:
    v: Number of miscarriages and/or abortions
  type:
    v: integer
  required:
    v: true
  repeats:
    v: false
  read only:
    v: false

id:
  v: HIV.E.DE14
link id:
  v: HIV.E.DE14
text:
  v: Number of live births
type:
  v: integer
required:
  v: true
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE15
link id:
  v: HIV.E.DE15
text:
  v: Number of caesarian sections
type:
  v: integer
required:
  v: true
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE16
link id:
  v: HIV.E.DE16
text:
  v: Number of stillbirths
type:
  v: integer
required:
  v: true
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE17
link id:
  v: HIV.E.DE17
text:
  v: Past pregnancy complications
type:
  v: choice
required:
  v: false
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE17
  l: HIV.E.DE17

id:
  v: HIV.E.DE35
link id:
  v: HIV.E.DE35
text:
  v: Other past pregnancy problems (specify)
type:
  v: string
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE36
link id:
  v: HIV.E.DE36
text:
  v: Parity
type:
  v: integer
required:
  v: true
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE37
link id:
  v: HIV.E.DE37
text:
  v: Pregnancy in HIV-infected woman
type:
  v: boolean
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE38
link id:
  v: HIV.E.DE38
text:
  v: Date new pregnancy of HIV-positive woman identified
type:
  v: date
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE39
link id:
  v: HIV.E.DE39
text:
  v: ANC contact during pregnancy
type:
  v: boolean
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE40
link id:
  v: HIV.E.DE40
text:
  v: Date of first ANC visit
type:
  v: date
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE41
link id:
  v: HIV.E.DE41
text:
  v: Timing of ART initiation
type:
  v: choice
required:
  v: false
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE41
  l: HIV.E.DE41

id:
  v: HIV.E.DE45
link id:
  v: HIV.E.DE45
text:
  v: Maternal use of recommended ART regimen
type:
  v: boolean
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE46
link id:
  v: HIV.E.DE46
text:
  v: Delivery date
type:
  v: date
required:
  v: true
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE47
link id:
  v: HIV.E.DE47
text:
  v: Pregnancy outcome
type:
  v: choice
required:
  v: false
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE47
  l: HIV.E.DE47

id:
  v: HIV.E.DE52
link id:
  v: HIV.E.DE52
text:
  v: Delivery mode
type:
  v: choice
required:
  v: false
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE52
  l: HIV.E.DE52

id:
  v: HIV.E.DE56
link id:
  v: HIV.E.DE56
text:
  v: Indications for caesarian section (C/S)
type:
  v: string
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE57
link id:
  v: HIV.E.DE57
text:
  v: Obstetric complications
type:
  v: string
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE58
link id:
  v: HIV.E.DE58
text:
  v: Live birth
type:
  v: boolean
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE59
link id:
  v: HIV.E.DE59
text:
  v: Live birth to an HIV-positive woman
type:
  v: boolean
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE60
link id:
  v: HIV.E.DE60
text:
  v: Gestational age at birth
type:
  v: integer
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE61
link id:
  v: HIV.E.DE61
text:
  v: Small for gestational age (SGA)
type:
  v: boolean
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE62
link id:
  v: HIV.E.DE62
text:
  v: Preterm birth status
type:
  v: choice
required:
  v: false
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE62
  l: HIV.E.DE62

id:
  v: HIV.E.DE66
link id:
  v: HIV.E.DE66
text:
  v: Maternal ART start date
type:
  v: date
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE67
link id:
  v: HIV.E.DE67
text:
  v: Place of delivery
type:
  v: choice
required:
  v: true
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE67
  l: HIV.E.DE67

id:
  v: HIV.E.DE71
link id:
  v: HIV.E.DE71
text:
  v: Other (specify)
type:
  v: string
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE72
link id:
  v: HIV.E.DE72
text:
  v: Delivery facility
type:
  v: string
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE73
link id:
  v: HIV.E.DE73
text:
  v: Date of miscarriage or abortion
type:
  v: date
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE76
link id:
  v: HIV.E.DE76
text:
  v: Infant's first name
type:
  v: string
required:
  v: true
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE77
link id:
  v: HIV.E.DE77
text:
  v: Infant's surname
type:
  v: string
required:
  v: true
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE78
link id:
  v: HIV.E.DE78
text:
  v: Infant's unique ID
type:
  v: string
required:
  v: true
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE79
link id:
  v: HIV.E.DE79
text:
  v: Mother's first name
type:
  v: string
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE80
link id:
  v: HIV.E.DE80
text:
  v: Mother's surname
type:
  v: string
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE81
link id:
  v: HIV.E.DE81
text:
  v: Mother's unique ID
type:
  v: string
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE82
link id:
  v: HIV.E.DE82
text:
  v: Caregiver's first name
type:
  v: string
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE83
link id:
  v: HIV.E.DE83
text:
  v: Caregiver's surname
type:
  v: string
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE84
link id:
  v: HIV.E.DE84
text:
  v: Caregiver's unique identifier
type:
  v: string
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE85
link id:
  v: HIV.E.DE85
text:
  v: ANC contact date
type:
  v: dateTime
required:
  v: true
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE86
link id:
  v: HIV.E.DE86
text:
  v: Referral
type:
  v: boolean
required:
  v: true
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE87
link id:
  v: HIV.E.DE87
text:
  v: Infant date of birth
type:
  v: date
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE88
link id:
  v: HIV.E.DE88
text:
  v: Date of birth of infant unknown
type:
  v: boolean
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE89
link id:
  v: HIV.E.DE89
text:
  v: Estimated age of infant
type:
  v: integer
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE90
link id:
  v: HIV.E.DE90
text:
  v: Age of infant
type:
  v: integer
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE91
link id:
  v: HIV.E.DE91
text:
  v: Gender of infant
type:
  v: choice
required:
  v: true
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE91
  l: HIV.E.DE91

id:
  v: HIV.E.DE113
link id:
  v: HIV.E.DE113
text:
  v: Key population member
type:
  v: boolean
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE114
link id:
  v: HIV.E.DE114
text:
  v: Key population member type
type:
  v: choice
required:
  v: false
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE114
  l: HIV.E.DE114

id:
  v: HIV.E.DE134
link id:
  v: HIV.E.DE134
text:
  v: Taking iron and folic acid (IFA) tablets
type:
  v: boolean
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE135
link id:
  v: HIV.E.DE135
text:
  v: Amount of iron prescribed
type:
  v: integer
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE136
link id:
  v: HIV.E.DE136
text:
  v: Type of iron supplement dosage provided
type:
  v: choice
required:
  v: false
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE136
  l: HIV.E.DE136

id:
  v: HIV.E.DE139
link id:
  v: HIV.E.DE139
text:
  v: Amount of daily dose of folic acid prescribed
type:
  v: integer
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE141
link id:
  v: HIV.E.DE141
text:
  v: Maternal HIV status
type:
  v: choice
required:
  v: false
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE141
  l: HIV.E.DE141

id:
  v: HIV.E.DE145
link id:
  v: HIV.E.DE145
text:
  v: Maternal HIV status at first ANC visit
type:
  v: choice
required:
  v: false
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE145
  l: HIV.E.DE145

id:
  v: HIV.E.DE155
link id:
  v: HIV.E.DE155
text:
  v: Signs of substantial risk of HIV infection
type:
  v: choice
required:
  v: true
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE155
  l: HIV.E.DE155

id:
  v: HIV.E.DE160
link id:
  v: HIV.E.DE160
text:
  v: Serodiscordant partner
type:
  v: boolean
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE161
link id:
  v: HIV.E.DE161
text:
  v: Date woman received counselling for CPT
type:
  v: date
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE162
link id:
  v: HIV.E.DE162
text:
  v: Date woman received counselling for TPT
type:
  v: date
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE173
link id:
  v: HIV.E.DE173
text:
  v: Maternal and child health service visit
type:
  v: choice
required:
  v: false
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE173
  l: HIV.E.DE173

id:
  v: HIV.E.DE177
link id:
  v: HIV.E.DE177
text:
  v: Weeks postpartum
type:
  v: integer
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE243
link id:
  v: HIV.E.DE243
text:
  v: Timing of additional infant HIV test
type:
  v: integer
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE244
link id:
  v: HIV.E.DE244
text:
  v: Date of sample collection of additional infant HIV test
type:
  v: date
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE245
link id:
  v: HIV.E.DE245
text:
  v: Haemoglobin (Hb) result
type:
  v: integer
required:
  v: false
repeats:
  v: false
read only:
  v: false

id:
  v: HIV.E.DE246
link id:
  v: HIV.E.DE246
text:
  v: Blood group and Rh factor
type:
  v: choice
required:
  v: false
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE246
  l: HIV.E.DE246

id:
  v: HIV.E.DE255
link id:
  v: HIV.E.DE255
text:
  v: Asymptomatic bacteriuria (ASB) test result
type:
  v: choice
required:
  v: false
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE255
  l: HIV.E.DE255

id:
  v: HIV.E.DE259
link id:
  v: HIV.E.DE259
text:
  v: Urine protein test result
type:
  v: choice
required:
  v: false
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE259
  l: HIV.E.DE259

id:
  v: HIV.E.DE264
link id:
  v: HIV.E.DE264
text:
  v: Type of hypertensive disorder
type:
  v: choice
required:
  v: false
repeats:
  v: false
read only:
  v: false
answer value set:
  v: #HIV.E.DE264
  l: HIV.E.DE264