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Reproductive Health: Part-I: Demographic Data
Reproductive Health: Part-I: Demographic Data
Reproductive Health: Part-I: Demographic Data
Instructions: Here are some personal questions which will be kept confidential. Please complete
the following by placing tick ( ). Mark in the appropriate column.
1. Age in years:
a) 11 - 12 years ( )
b) 13 - 14 years ( )
c) 15 - 16 years ( )
d) Above 16 years ( )
2. Educational status:
a) 8th standard ( )
b) 9th standard ( )
3. Religion:
a) Hindu ( )
b) Muslim ( )
c) Christian ( )
d) Others ( )
4. Residence :
a) Urban ( )
b) Semi urban ( )
c) Rural ( )
5. Father’s education :
a) Primary education ( )
b) Secondary education ( )
c) PUC ( )
d) Graduate and above ( )
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6. Mother’s education:
a) Primary education ( )
b) Secondary education ( )
c) PUC ( )
d) Graduate and above ( )
7. Father’s occupation:
a) Government employee ( )
b) Private employee ( )
c) Own business ( )
d) Others ( )
8. Mother’s occupation:
a) Government employee ( )
b) Private employee ( )
c) Own business ( )
d) House Wife ( )
9. Family Income:
a) <10000 ( )
b) 10000-20000 ( )
c) 20000-30000 ( )
d) >30000 ( )
a) Yes ( )
b) No ( )
a) Electronic media ( )
b) Printed media ( )
c) Friend/ Family/ Teachers ( )
d) others ( )
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PART – II : GENERAL KNOWLEDGE ON REPRODUCTIVE HEALTH
Instructions:
a) Above 15 years ( )
b) After the age of 18 ( )
c) After the age of 21 ( )
d) After the age of 30 ( )
2. Most visible changes that occur in a girls physic during puberty are:
a) Ovulation ( )
b) Increased hormonal levels ( )
c) Attraction towards opposite sex ( )
d) Increased age ( )
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5. Female sex cell is named as:
a) Sperm ( )
b) Zygote ( )
c) Ovum ( )
d) Embryo ( )
a) Fertilization ( )
b) Ovulation ( )
c) Menstruation ( )
d) Evolution ( )
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SECTION B: KNOWLEDGE REGARDING MENSTRUATION AND MENSTRUAL HYGIENE
1. Menstruation is:
a) Menarche ( )
b) Puberty ( )
c) Menopause ( )
d) First Period ( )
a) Hormonal changes ( )
b) Bad blood is being purified ( )
c) Body waste is removed ( )
d) Women’s fate ( )
a) Before 9 years ( )
b) 10-13 years ( )
c) 14-17 years ( )
d) 18-24 years ( )
a) 30 ml ( )
b) 60-120 ml ( )
c) 200 ml ( )
d) More than 200 ml ( )
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6. Duration of normal menstrual cycle is:
a) 1-3 days ( )
b) 3-5 days ( )
c) 5-7 days ( )
d) 7-10 days ( )
a) Uterus ( )
b) Vagina ( )
c) Bladder ( )
d) Abdomen ( )
a) Once a day ( )
b) Twice a day ( )
c) Four times a day ( )
d) Whenever soaked ( )
9. The correct technique to clean the hands after placing the pad is:
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SECTION C: KNOWLEDGE REGARDING PREGNANCY AND CARE
a) 15-17 years ( )
b) 18-20 years ( )
c) 21-30 years ( )
d) Above 30 years ( )
a) Missing periods ( )
b) Breast enlargement ( )
c) Frequency in urination ( )
d) Nausea/vomiting ( )
a) Alcohol, tobacco ( )
b) Fruits ( )
c) Walking ( )
d) Sex ( )
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SECTION D: KNOWLEDGE REGARDING FAMILY PLANNING AND STDS
a) 1-2 years ( )
b) 2-3 years ( )
c) 4-5 years ( )
d) 5-7 years ( )
a) Copper t ( )
b) Oral pills ( )
c) Tubectomy ( )
d) Vasectomy ( )
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7. HIV can be transmitted through which measure?
a) Hugging ( )
b) Shaking hands ( )
c) Mosquito bites ( )
d) Blood contaminated body fluids ( )
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