RESEARCH QUESTIONNAIRE

Introduction: I am Ninsiima……………., a student at Africa Renewal University. Currently

conducting a study on “Factors Influencing Access to Adolescent-Friendly Services among
Female Students in Rukungiri district; a case study of Immaculate Heart Girls' School
Nyakibale. Your input is crucial for understanding the factors that influence access to adolescent-
friendly services among female students. Please answer the following questions honestly and to
the best of your knowledge.

Section A: Demographic Information

1.1. Age: What is your current age?...................... [Open-ended response]
1.2. Sex: Please indicate your gender.
 Female
 Male
1.3. Grade/level of education

Primary
Secondary
Tertiary (college/university)
1.4. Ethnicity: ______________________
1.5 Current Residence: ________

Rural
Urban
1.6 How would you describe your overall health?
a. Excellent b. Good c. Fair d. Poor
1.7. Are you currently in a relationship?
Yes
No
1.8. Socioeconomic Status:
How would you describe your family's socioeconomic status?
Low income
Middle income
High income

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Section B2: Knowledge and Awareness
2.1. Knowledge Level: How would you rate your knowledge about reproductive health and
adolescent-friendly services?
 Very Low
 Low
 Moderate
 High
 Very High
2.2. Awareness of SRH (Sexual and Reproductive Health): Are you aware of sexual and
reproductive health services available to adolescents?
1=Yes 0=No 9=Not sure
Section B3: Sexual Activities
3.1. Sexual Activity: Have you ever engaged in sexual activities?
1=Yes 0=No 9=Prefer not to answer
3.2. If Yes, At what age did you first engage in sexual activities? ………………..
3.3 If Yes, Have you received information or support related to sexual and reproductive health
after becoming sexually active?
1=Yes 0=No 9=Prefer not to answer
Section B4: Availability of Services
4.1 How satisfied are you with the availability of adolescent-friendly services at the facility?
a. Very satisfied b. Satisfied c. Neutral d. Dissatisfied e. Very dissatisfied
4.2 Have you ever faced challenges in accessing the required healthcare services at the facility?
1=Yes 0=No 9=Not sure
4.3 If yes, please describe the challenges you faced in accessing healthcare services:
4.4 How would you rate the waiting time at the adolescent-friendly services facility?
a. Very short b. Short c. Acceptable d. Long e. Very long
4.5 Have you ever experienced excessive waiting times that negatively impacted your experience
at the facility?
1=Yes 0=No 9=Not sure

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Section C: Family Support
C.1. On a scale of 1 to 5, how would you rate the level of support you receive from your family
regarding your health and well-being? (1 = Low support, 5 = High support)
C.2. In what ways does your family support or hinder your access to adolescent-friendly
services? (Open-ended)
C3. How does your family influence your access to adolescent-friendly services? Please select
the options that apply.
C3.1 Supportive Factors:

Open communication about health issues

Willingness to accompany you to service locations
Financial support for health-related expenses
Encouragement to seek services when needed
Knowledge about available adolescent-friendly services
Others (please specify): ____________
C3.2 Hindering Factors:
Lack of awareness about your health needs
Reluctance to discuss health matters
Financial constraints hindering service utilization
Disapproval or stigma associated with seeking services
Cultural or religious beliefs limiting access
Others (please specify): ____________
C.4 To what extent do you feel comfortable discussing your health concerns with your family?

Very comfortable
Comfortable
Neutral
Uncomfortable
Very uncomfortable
Section C5: School Support
C5.1. How aware are you of the health services available at your school?

Not aware
Somewhat aware

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 Very aware
C5.2. To what extent do you feel supported by the school in seeking and utilizing health
services?

Not supported at all

Somewhat supported
Very supported
Section D: Myths & Misconceptions
D.1. Are there any myths or misconceptions in your community that affect your willingness to
access adolescent-friendly services?
1=Yes 0=No
D.2 In what ways do these myths or misconceptions influence your decision-making regarding
health services? Please select the options that apply.
D2.1 Decision-Making Factors:

Avoidance of seeking health services

Delay in seeking health services
Preference for traditional remedies over professional services
Fear or anxiety about the consequences of seeking services
Influence on the choice of specific health services
Others (please specify): ____________
D2.2 Impact on Health Behavior:

Reluctance to discuss health concerns with professionals

Resistance to following medical advice or recommendations
Adoption of alternative or unproven health practices
Discontinuation of prescribed treatments
Others (please specify): ____________
D3. Do your friends play a role in influencing your decisions about accessing health services?
1=Yes 0=No
D4. If yes, in what ways do your peers influence your decisions?
Section E: Community Awareness
E.1. How would you rate the level of awareness in your community regarding available
adolescent-friendly services?
1=Low awareness, 2=Moderate awareness, 3=High awareness

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E.2 How would you rate the overall attitude of health workers at the adolescent-friendly services
facility?
a. Excellent b. Good c. Neutral d. Poor
E.3 Have you ever felt judged or uncomfortable while seeking healthcare services from health
workers?
1=Yes 0=No 9= Not sure
E.4 How satisfied are you with the quality of interactions with healthcare staff at the facility?
a. Very satisfied b. Satisfied c. Neutral d. Dissatisfied e. Very dissatisfied
E.5 Have you ever felt that the quality of interactions with healthcare staff could be improved?
1=Yes 0=No 9= Not sure

Section F: Utilization and Access of SRH Services & contraceptives

F2.1 How frequently do you utilize Sexual and Reproductive Health (SRH) services?

Never
Rarely
Occasionally
Frequently
Always
F2.2 If you have utilized SRH services, please specify the types of services you have accessed

Counselling
Testing
Contraceptives
Education programs
Health clinics
Other, specify
F3.1 How would you rate the ease of access to information on Sexual and Reproductive Health
(SRH)?

Very Difficult
Difficult
Neutral
Easy

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 Very Easy
F3.2 Where do you usually seek information on SRH? (Select all that apply)

School programs
Healthcare providers
Friends
Family
Internet
Other (please specify): _______________

F4.1 Have you ever used contraceptives?

1=Yes 0=No 9= Not sure
F4.2 If yes, please specify the type(s) of contraceptives you have used:

Hormonal contraceptives (Birth control pills, patches, injections, vaginal ring etc)
Barrier methods (condoms, diaphragm, cervical cap, sponge etc)
Intrauterine devices (IUDs) like copper IUD, Hormonal IUD
Emergency contraception like morning pills, IUD for emergency
Natural methods like withdrawal, fertility awareness-based methods etc
Permanent Methods like tubal ligation, vasectomy
Dual protection (Simultaneous use of condoms and another contraceptive method)
Others (please specify): _________

Section G: Knowledge of Available Services

G5.1 How would you rate your knowledge of available adolescent-friendly services?

Very Low
Low
Neutral
High
Very High
G5.2 What sources have contributed most to your knowledge of available services? (Select all
that apply)

School education

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 Healthcare providers
Media (TV, radio, etc.)
Friends
Family
Other (please specify): _______________

Section H: Behavioural changes and knowledge

H4.1. How would you rate your knowledge about safe sexual practices?

Very Low
Low
Moderate
High
Very High
H4.2. Adoption of Safe Sexual Practices: Have you adopted any safe sexual practices as a
result of accessing adolescent-friendly services?
1=Yes 0=No
H4.1. To what extent do you feel empowered to make decisions about your sexual health?
 Not at all empowered
 Slightly empowered
 Moderately empowered
 Very empowered
 Extremely empowered
H4.2. Have there been any changes in your decision-making regarding sexual health since
accessing adolescent-friendly services?
1=Yes 0=No 9=Not sure
H4.3. If yes, please describe the changes you have experienced.
Changes in Knowledge and Attitudes Toward SRH:
H4.4. How has your knowledge about Sexual and Reproductive Health changed over time?
 Increased significantly
 Increased moderately
 Remained the same
 Decreased moderately

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  Decreased significantly
5.2. Do you believe your attitudes toward Sexual and Reproductive Health have changed as a
result of accessing adolescent-friendly services?
1=Yes 0=No 9=Not sure
Health outcomes section
I.1 Have you ever experienced an unplanned pregnancy?
1=Yes 0=No 9=Prefer not to answer
I.2 If yes, at what age did it occur? ………………
I.3 Were you able to access reproductive health services during the unplanned pregnancy?
1=Yes 0=No 9=Prefer not to answer
I.4 Have you ever been tested for STIs, including HIV? 1=Yes 0= No 9= Not sure
I.5 If yes, please indicate the results: 0=Negative 1= Positive 9= Prefer not to answer
I.6 Were you able to access appropriate treatment and counseling after receiving your test
results?
1=Yes 0=No 9=Not applicable
I.7 How would you rate your overall reproductive health? [ ] Excellent [ ] Good [ ] Fair [ ] Poor
I.8 Have you faced any challenges in accessing reproductive health information or services?
1=Yes 0=No
I.9 Are you currently attending school? 1=Yes 0=No
I.10 If no, please indicate the reason for not attending school:
I.11 Have you ever dropped out of school?
1=Yes 0=No 9=Not applicable
I.12 If yes, please indicate the reasons for dropping out:
………………………………………………………..
I.13 What are the main factors that influence your access to adolescent-friendly services? (Please
select all that apply)

Lack of information
Stigma associated with seeking services
Limited confidentiality
Distance to service locations
Cultural or religious barriers

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 Others (please specify): ____________
I.14 How comfortable do you feel discussing your health concerns with service providers?

Very comfortable
Comfortable
Neutral
Uncomfortable
Very uncomfortable
I.15 Have you ever experienced limited access to adolescent-friendly services?
1=Yes 0=No
I.16 Do you think there is a need for awareness campaigns or educational programs regarding
these services?
1=Yes 0=No 9=Not sure
Open-ended Questions
I.17 What role do you think schools/colleges should play in improving access to these services?
I.18. Please share any challenges or barriers you have faced in accessing adolescent-friendly
services related to sexual and reproductive health. [Open-ended response]
I.19 Do you have any suggestions for improving the availability and accessibility of adolescent-
friendly services for female students? [Open-ended response]