Antenatal Care (ANC) – Routine Immunization Carepath
Purpose
The ANC Routine Immunization Carepath manages tetanus-containing immunizations for pregnant clientsthroughout pregnancy.
It applies national ANC immunization rules to automatically propose Td (Adult) doses at the correct time, based on:
The client’s prior DT/TD immunization history
Gestational age and remaining time before the Estimated Date of Delivery (EDD)
This carepath ensures pregnant clients receive appropriate tetanus protection while avoiding unnecessary or unsafe dosing.
This page explains how to:
Identify a pregnant patient
Manually enroll the patient into the ANC Routine Immunization Carepath
Review the proposed ANC Td schedule
Start the ANC immunization visit correctly
Record vaccines using Visit Actions
Update pregnancy details and document AEFI
End the visit and review remaining doses
Navigation
From the sidebar, expand Patients and select Search.
Search for the patient using one or more identifiers
Open the patient’s View Patient page
When Pregnancy Status is recorded as Active, the ANC Routine Immunization Carepath becomes available under Care Pathways / Plans.
⚠️ Care paths are never enrolled automatically.
You must manually select Enroll to activate the ANC carepath and begin scheduling Td doses.
Workflow
Review the ANC Immunization Schedule
After enrollment, the carepath displays Td doses scheduled based on:
Prior DT/TD history
Time remaining before EDD
The system applies the following rules:
Td1 appears if due and >14 days before EDD
Td2 appears ≥4 weeks after Td1 and >42 days before EDD
Td3 appears ≥6 months after Td2 and >10 days before EDD
If fully vaccinated pre-pregnancy (≥5 valid tetanus doses), no Td is proposed
If partially immunized, a single booster may be proposed
Start the ANC Visit
Open the scheduled Antenatal Care Visit (Immunization) and select Start Visit.
In the Start Visit dialog:
Select From Care Plan – ANC Routine Immunization Carepath
Confirm all required fields are complete
Review the Check-In Date/Time
Required Fields Explained
If Start Visit is disabled, review the highlighted sections:
Stock / Clinic Session An active clinic session must be selected so Td stock can be issued and tracked.
Check-In Date/Time Defaults to the current time, but can be adjusted if care occurred earlier (e.g., outreach, delayed data entry, offline work).
Template Automatically satisfied when starting From Care Plan and does not require manual selection.
Completing all required fields enables the Start Visit button.
Select Start Visit to open the ANC immunization visit.
Save, Return, or End
Use Save at any time to preserve progress.
If additional services are required, select Return to Waiting Room.
Linkage to the Pediatric DT Schedule
The ANC Td schedule accounts for DT/TD doses received in childhood and adolescence, ensuring lifetime tetanus protection.
0 doses
Td1, Td2, Td3 (if timing allows)
1–2 doses
Td1, Td2
3–4 doses
Td1 (single booster)
≥5 doses
None required
The system verifies historical DT/TD records (including pediatric and school-age doses) to determine the remaining doses required for full protection.
For pediatric scheduling details, see Healthy Baby / Child Carepath – Visit Actions, which documents the DT pediatric schedule and Visit Actions workflow.
Summary
The ANC Routine Immunization Carepath ensures pregnant clients receive the correct tetanus-containing vaccines at the appropriate time during pregnancy.
By manually enrolling the carepath, starting the visit from the care plan, recording vaccines through Visit Actions, and accurately managing check-in time and stock sessions, clinic staff ensure:
Safe, guideline-compliant immunization
Accurate stock accountability
Correct visit classification and reporting
Reliable follow-up scheduling
Consistent use of this workflow supports high-quality ANC care and trustworthy national immunization data.
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