Integrated Campaign Registry (ICR) Implementation Guide
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Integrated Campaign Registry (ICR) Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: ICR Refusal Reason - TTL Representation

Draft as of 2026-08-07

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/icr-noncompliance-reason-cs> a fhir:CodeSystem ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "icr-noncompliance-reason-cs"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem icr-noncompliance-reason-cs</b></p><a name=\"icr-noncompliance-reason-cs\"> </a><a name=\"hcicr-noncompliance-reason-cs\"> </a><p>This case-sensitive code system <code>https://icr.healthcampaigns.org/CodeSystem/icr-noncompliance-reason-cs</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">safety-concern<a name=\"icr-noncompliance-reason-cs-safety-concern\"> </a></td><td>Safety concern / fear of adverse events</td><td>Fear of AEFI or medicine side effects.</td></tr><tr><td style=\"white-space:nowrap\">religious-objection<a name=\"icr-noncompliance-reason-cs-religious-objection\"> </a></td><td>Religious or cultural objection</td><td>Belief-based objection.</td></tr><tr><td style=\"white-space:nowrap\">no-felt-need<a name=\"icr-noncompliance-reason-cs-no-felt-need\"> </a></td><td>No felt need</td><td>Does not consider the intervention necessary (e.g. child already vaccinated, not at risk).</td></tr><tr><td style=\"white-space:nowrap\">campaign-fatigue<a name=\"icr-noncompliance-reason-cs-campaign-fatigue\"> </a></td><td>Campaign fatigue</td><td>Too many rounds; declines further participation.</td></tr><tr><td style=\"white-space:nowrap\">misinformation<a name=\"icr-noncompliance-reason-cs-misinformation\"> </a></td><td>Misinformation / rumor</td><td>Declines based on circulating misinformation (including disease-specific rumours — e.g. 'Africa is polio-free', vaccine-specific concerns; localise via ConceptMap).</td></tr><tr><td style=\"white-space:nowrap\">not-decision-maker<a name=\"icr-noncompliance-reason-cs-not-decision-maker\"> </a></td><td>Not the decision-maker</td><td>The person present could not consent; the household decision-maker was absent. Recurring polio SIA refusal reason (forms-v1 / jul3-form-analysis Aggregate #4).</td></tr><tr><td style=\"white-space:nowrap\">other<a name=\"icr-noncompliance-reason-cs-other\"> </a></td><td>Other</td><td>Other reason — record detail in text.</td></tr></table></div>"
  ] ;
  fhir:CodeSystem.url [ fhir:value "https://icr.healthcampaigns.org/CodeSystem/icr-noncompliance-reason-cs"] ;
  fhir:CodeSystem.version [ fhir:value "0.1.0"] ;
  fhir:CodeSystem.name [ fhir:value "ICRNoncomplianceReasonCS"] ;
  fhir:CodeSystem.title [ fhir:value "ICR Refusal Reason"] ;
  fhir:CodeSystem.status [ fhir:value "draft"] ;
  fhir:CodeSystem.experimental [ fhir:value "false"^^xsd:boolean] ;
  fhir:CodeSystem.date [ fhir:value "2026-08-07T08:41:18-04:00"^^xsd:dateTime] ;
  fhir:CodeSystem.publisher [ fhir:value "UNICEF"] ;
  fhir:CodeSystem.contact [
     fhir:index 0 ;
     fhir:ContactDetail.name [ fhir:value "UNICEF" ] ;
     fhir:ContactDetail.telecom [
       fhir:index 0 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "https://www.unicef.org" ]
     ]
  ] ;
  fhir:CodeSystem.description [ fhir:value "Why a household or caregiver refused the intervention (WHO IDHC: 'intervention refusal'; ESPEN forms say noncompliance) — drives social-mobilization targeting and mop-up planning."] ;
  fhir:CodeSystem.jurisdiction [
     fhir:index 0 ;
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "http://unstats.un.org/unsd/methods/m49/m49.htm" ] ;
       fhir:Coding.code [ fhir:value "001" ] ;
       fhir:Coding.display [ fhir:value "World" ]
     ]
  ] ;
  fhir:CodeSystem.caseSensitive [ fhir:value "true"^^xsd:boolean] ;
  fhir:CodeSystem.content [ fhir:value "complete"] ;
  fhir:CodeSystem.count [ fhir:value "7"^^xsd:nonNegativeInteger] ;
  fhir:CodeSystem.concept [
     fhir:index 0 ;
     fhir:CodeSystem.concept.code [ fhir:value "safety-concern" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Safety concern / fear of adverse events" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Fear of AEFI or medicine side effects." ]
  ], [
     fhir:index 1 ;
     fhir:CodeSystem.concept.code [ fhir:value "religious-objection" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Religious or cultural objection" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Belief-based objection." ]
  ], [
     fhir:index 2 ;
     fhir:CodeSystem.concept.code [ fhir:value "no-felt-need" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "No felt need" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Does not consider the intervention necessary (e.g. child already vaccinated, not at risk)." ]
  ], [
     fhir:index 3 ;
     fhir:CodeSystem.concept.code [ fhir:value "campaign-fatigue" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Campaign fatigue" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Too many rounds; declines further participation." ]
  ], [
     fhir:index 4 ;
     fhir:CodeSystem.concept.code [ fhir:value "misinformation" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Misinformation / rumor" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Declines based on circulating misinformation (including disease-specific rumours — e.g. 'Africa is polio-free', vaccine-specific concerns; localise via ConceptMap)." ]
  ], [
     fhir:index 5 ;
     fhir:CodeSystem.concept.code [ fhir:value "not-decision-maker" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Not the decision-maker" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The person present could not consent; the household decision-maker was absent. Recurring polio SIA refusal reason (forms-v1 / jul3-form-analysis Aggregate #4)." ]
  ], [
     fhir:index 6 ;
     fhir:CodeSystem.concept.code [ fhir:value "other" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Other" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Other reason — record detail in text." ]
  ] .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/icr-noncompliance-reason-cs.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/CodeSystem/icr-noncompliance-reason-cs.ttl> .