Professional Documents
Culture Documents
Adolescent Girls Health Survey - July19 - v2
Adolescent Girls Health Survey - July19 - v2
Adolescent Girls Health Survey - July19 - v2
Village
Caste
Do you go to school?
SOURCE OF INFO
1. What is your most important source for finding out about menstruation?
[choose one]
Mother
Sister
Sister-in-law
Friends
School Teacher
ASHA worker
Taruni Sakhi/Prerak
ANM
Do not know
2. Have you ever told any of your friends about what you learned in school about
menstruation?
Yes
No
KNOWLEDGE
No
Yes
No
Yes
No
5. a. If yes, how?
Mother
Sister
Sister-in-law
Friends
School Teacher
ASHA worker
Taruni Sakhi/Prerak
Others ____
Yes
No
7. Please list all the hygiene (saaf safai) practices you use during menstruation?
[choose multiple]
Bathing daily
Burn
Yes
No
ATTITUDES/PERCEPTION
Important
Not Important
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
10. When do you think girls should get married (at what age)?
Below 18
18-20
20-22
22-24
After 24
Yes
No
12. How many times have you used cloth during your periods?
1-2 times
2-3 times
3-4 times
Never
13. Have you ever not attended school because of period related problems?
Yes
No
14. Have you ever faced any medical problem from using cloth or pads during
periods? [Choose Multiple]
Rashes
Itching
Skin Problems
None
Others _____
15. What issues related to periods cause stress/worry you? (tension hoti hai)
[choose multiple]
Delay in periods
Irregular periods
None
Others ____
16. If any selected, whom do you go to when you face these problems? [Choose
Multiple]
Mother
Sister
Sister-in-law
Friends
School Teacher
ASHA worker
Taruni Sakhi/Prerak
ANM
Internet
Bengali Doctor
Public Hospital
Private Hospital
No One
Others ____
16. a. If no one, why do you not reach out to anyone? [choose multiple]
Shyness
Others _____
17. Who are you comfortable speaking about your periods to? [choose multiple]
Mother
Sister
Sister-in-law
Friends
School Teacher
ASHA worker
Taruni Sakhi/Prerak
ANM
Doctor (hospital)
No one
WATER
Yes
No
Well
Handpump
River
Tanker
Others ____
0 – 15 minutes
15 – 30 minutes
30 – 45 minutes
PHONE USAGE
19. Do you own a WhatsApp phone?
Yes
No
19. a. If no, does anyone in your family own a WhatsApp phone that you open
WhatsApp on?
Yes
No
Never
Information/knowledge
WhatsApp groups
Talking to friends
Sending photos
Sending videos/music
Others: _____