FHIR IG analytics| Package | ethiopia.fhir.hiv |
| Resource Type | Questionnaire |
| Id | Questionnaire-IndexCaseAssessmentQuestionnaire.json |
| FHIR Version | R4 |
| Source | https://build.fhir.org/ig/jembi/ethiopia-hiv/Questionnaire-IndexCaseAssessmentQuestionnaire.html |
| URL | http://moh.gov.et/fhir/hiv/Questionnaire/IndexCaseAssessmentQuestionnaire |
| Version | 1.0.1 |
| Status | active |
| Date | 2026-02-09T05:22:58+00:00 |
| Name | IndexCaseAssessmentQuestionnaire |
| Title | Questionnaire - Index Case Assessment |
| Description | A questionaire that assesses the index case during interviews. |
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Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire IndexCaseAssessmentQuestionnaire
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  IndexCaseAssessmentQuestionnaire | A questionaire that assesses the index case during interviews. | Questionnaire | http://moh.gov.et/fhir/hiv/Questionnaire/IndexCaseAssessmentQuestionnaire#1.0.1 | |
  1.1 | Did the index case agree to be interviewed | 0..1 | choice | Value Set: Yes/No Codes |
| 1.2 | Reason for not being interviewed | 0..1 | choice | Value Set: Reason Index Case Not Interviewed |
 1.3 | Other Reason for not being interviewed | 1..1 | string | Enable When: 1.2 = |
 1.4 | When did the index case receive the interview | 1..1 | date | Enable When: 1.1 = |
| 1.5 | Was the index case interviewed for partner services | 0..1 | choice | Value Set: Yes/No Codes |
| 1.6 | When was the index case interviewed for partner services | 1..1 | date | Enable When: 1.5 = |
 1.7 | Number of sexual partners in past 12 months | 0..1 | integer | |
| 1.8 | Number of sexual partners in past 24 months | 0..1 | integer | |
| 1.9 | Is the index client willing to identify the sex partners | 0..1 | choice | Value Set: Yes/No Codes |
| 1.10 | Reason for not being able to identify the sex partners | 1..1 | string | Enable When: 1.9 = |
 1.11 | What is the next visit date | 0..1 | date | |
| Documentation for this format | ||||
FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "IndexCaseAssessmentQuestionnaire",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"url": "http://moh.gov.et/fhir/hiv/Questionnaire/IndexCaseAssessmentQuestionnaire",
"version": "1.0.1",
"name": "IndexCaseAssessmentQuestionnaire",
"title": "Questionnaire - Index Case Assessment",
"status": "active",
"subjectType": [
"Observation"
],
"date": "2026-02-09T05:22:58+00:00",
"publisher": "Jembi Health Systems",
"contact": [
{
"name": "Jembi Health Systems",
"telecom": [
{
"system": "url",
"value": "https://www.jembi.org"
},
{
"system": "email",
"value": "info@jembi.org"
}
]
},
{
"name": "Jembi Health Systems",
"telecom": [
{
"system": "email",
"value": "info@jembi.org",
"use": "work"
}
]
}
],
"description": "A questionaire that assesses the index case during interviews.",
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "ET",
"display": "Ethiopia"
}
]
}
],
"item": [
{
"linkId": "1.1",
"code": [
{
"system": "http://loinc.org",
"code": "LA14870-2"
}
],
"text": "Did the index case agree to be interviewed",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/yes-no-value-set"
},
{
"linkId": "1.2",
"code": [
{
"system": "http://loinc.org",
"code": "LP95022-7"
}
],
"text": "Reason for not being interviewed",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/reason-index-case-not-interviewed-value-set"
},
{
"linkId": "1.3",
"code": [
{
"system": "http://snomed.info/sct",
"code": "410666004"
}
],
"text": "Other Reason for not being interviewed",
"type": "string",
"enableWhen": [
{
"question": "1.2",
"operator": "=",
"answerCoding": {
"system": "http://loinc.org",
"code": "LA46-8"
}
}
],
"required": true,
"repeats": false
},
{
"linkId": "1.4",
"code": [
{
"system": "http://loinc.org",
"code": "91714-6"
}
],
"text": "When did the index case receive the interview",
"type": "date",
"enableWhen": [
{
"question": "1.1",
"operator": "=",
"answerCoding": {
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/yes-no-code-system",
"code": "true"
}
}
],
"required": true,
"repeats": false
},
{
"linkId": "1.5",
"code": [
{
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/partner-and-fbict-code-system",
"code": "Partner-Services"
}
],
"text": "Was the index case interviewed for partner services",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/yes-no-value-set"
},
{
"linkId": "1.6",
"code": [
{
"system": "http://loinc.org",
"code": "91714-6"
}
],
"text": "When was the index case interviewed for partner services",
"type": "date",
"enableWhen": [
{
"question": "1.5",
"operator": "=",
"answerCoding": {
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/yes-no-code-system",
"code": "true"
}
}
],
"required": true,
"repeats": false
},
{
"linkId": "1.7",
"code": [
{
"system": "http://loinc.org",
"code": "85736-7"
}
],
"text": "Number of sexual partners in past 12 months",
"type": "integer",
"required": false,
"repeats": false
},
{
"linkId": "1.8",
"code": [
{
"system": "http://snomed.info/sct",
"code": "228458001"
}
],
"text": "Number of sexual partners in past 24 months",
"type": "integer",
"required": false,
"repeats": false
},
{
"linkId": "1.9",
"code": [
{
"system": "http://snomed.info/sct",
"code": "228465009"
}
],
"text": "Is the index client willing to identify the sex partners",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/yes-no-value-set"
},
{
"linkId": "1.10",
"code": [
{
"system": "http://snomed.info/sct",
"code": "225465005"
}
],
"text": "Reason for not being able to identify the sex partners",
"type": "string",
"enableWhen": [
{
"question": "1.9",
"operator": "=",
"answerCoding": {
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/yes-no-code-system",
"code": "false"
}
}
],
"required": true,
"repeats": false
},
{
"linkId": "1.11",
"code": [
{
"system": "http://loinc.org",
"code": "57070-5"
}
],
"text": "What is the next visit date",
"type": "date",
"required": false,
"repeats": false
}
]
}