Final Suhu

A COMPARATIVE STUDY TO ASSESS THE KNOWLEDGE AND
ATTITUDE REGARDING USE OF SANITARY PADS

AMONG ADOLESCENT GIRLS STUDYING IN
SELECTED SCHOOLS OF RURAL
AND URBAN AREAS OF
AHMEDABAD
MS. SUHANI ANILKUMAR JOSHI

MASTER OF SCIENCE IN
(COMMUNITY HEALTH NURSING)
OCTOBER-2021
GUJARAT UNIVERSITY, AHMEDABAD
AND URBAN AREAS OF
AHMEDABAD
RESEARCH GUIDE RESEARCH CO GUIDE
Ms. Sejal Shukla Mr. Ashok Sharma

R.N R.M M.Sc(N) R.N R.M M.Sc(N)
Assistant Professor, Assistant Professor
Shrey Institute of Nursing & Shrey Institute of Nursing &
Allied Sciences, Allied Sciences,
Ahmedabad. Ahmedabad.
INVESTIGATOR
MS. SUHANI A JOSHI

S.Y.M.Sc. NURSING
Shrey Institute of Nursing & Allied Sciences
Ahmedabad
A DISSERTATION SUBMITTED TO GUJARAT UNIVERSITY,

AHMEDABAD FOR PARTIAL FULFILLMENT OF THE
REQUIREMENT FOR DEGREE OF MASTER
OF SCIENCE IN COMMUNITY HEALTH
NURSING, OCTOBER 2021
It is certified that this is the Bonafied Research work
of
MS. SUHANI JOSHI
at
Shrey Institute of Nursing & Allied Sciences, Ahmedabad.
SUBMITTED FOR PARTIAL FULFILLMENT OF THE

REQUIREMENT FOR THE DEGREE OF MASTER OF SCIENCE
IN NURSING
Roll No:- Ms. Rina Mathew

S.Y.M.Sc Nursing R.N R.M M.Sc (N)
Principal (I/C)
Shrey Institute of Nursing and
Allied Sciences,
Ahmedabad
GUJARAT UNIVERSITY
OCTOBER-2021
DEDICATION
THIS THESIS IS DEDICATED TO MY BELOVED

PARENTS AND MY BEST FRIENDS (DIVYA,
PRATIXA, AND VATSAL)
ACKNOWLEDGEMENT
“I will praise you, lord, with all my heart.,
I will tell of all your wonders.”
This Dissertation became a reality with the help and kind support of many
individuals. I would like to extend my sincere thanks to all of them.
First and foremost, I want to offer this endeavor to the GOD Almighty, for the
wisdom he bestowed upon me, the strength, peace of my mind and good health and
for his showers of blessings throughout my research work to complete the research
successfully.
I express my sincere thanks to Mrs. Neeta Mahant & Mr. Bharat Mahant
Chairman, Shrey Institute of Nursing & Allied Sciences for giving me the opportunity
to undergo Master degree Training in Nursing.
With deep sense of gratitude, I express my sincere thanks to Ms. Rina
Mathew, Principal, Shrey Institute of nursing and Allied sciences, Ahmedabad. The
words of appreciation and encouraging support given by them kindled my spirit and
enthusiasm to go ahead and to accomplish this study successfully.
I would like to express my special gratitude and thanks to my Research Guide,
Ms. Sejal Shukla for imparting her knowledge and expertise in this study. I thank her
for untiring guidance, constructive criticism, valuable contribution, constant
encouragement, patience and personal interest. Her motivating words and living
attitude have laid the foundation for building up the present study. Her dedication and
keen interest above all her overwhelming attitude to help the students had been solely
and mainly responsible for completing my work. Her timely advice, scholarly advice
and scientific approach have helped me to a very great extent to accomplish this task.
I express great deal of immense thanks to Mr. Ashok k Sharma, Co-Guide,
who gave me the permission to conduct this research study and fully acknowledge her
contribution, guidance in completing this study. Her prompt inspirations, timely
suggestions with kindness, enthusiasm and dynamism have enables me to complete
my thesis.
I express my gratitude and thank to my Class Co-ordinator, Ms. Dincy Daniel
for the support and continuous guidance which helped me throughout my study.
I am highly indebted to faculties of Shrey Institute of Nursing & Allied
Sciences for their guidance and supervision as well as providing necessary
i
information regarding this research and also for their support in completing this
endeavor.
I would like to extend my thank to the Librarian, Ms. Kaushalya Parmar for
her kind co-operation and help throughout my study period.
I would like to express my gratitude towards my family for the encouragement
which helped me in completion of this paper. I am extremely grateful to my parents
for their love, prayers, care and sacrifices for preparing me for my future.
I would like to thank my classmates and samples of the study for their
cooperation and moral support throughout the research work.
Finally, my sincere thanks and gratitude to all those who have directly or
indirectly helped me in the successful completion of this dissertation.
Suhani Joshi
ii
INDEX
PAGE
CHAPTER CONTENT
NO.
1 INTRODUCTION
1.1 Background of the study 1
1.2 Need for study 4
1.3 Statement of the problem 6
1.4 Objectives 7
1.5 Assumptions 7
1.6 Operational definitions 8
1.7 Delimitation of the study 8
1.8 Conceptual framework 9
2 REVIEW OF LITERATURE
2.1 Literature related to the menstrual hygiene among 13
school girls.
2.2 Literature related to knowledge and attitude regarding 16
use of sanitary pads among adolescents girls.
3 RESEARCH METHEDOLOGY
3.1 Research approach 22
3.2 Research design 23
3.3 Research setting 25
3.4 Research variables 27
3.5 Target population 27
3.6 Sample size and sampling technique 27
3.7 Selection of tool for data collection 28
3.8 Development of tool for data collection 29
3.9 Description of tool 30
3.9 Validity of tool 32
3.10 Reliability of tool 32
3.11 Pilot study 34
3.12 Procedure for data collection 34
3.13 Plan for data analysis 34
iii
PAGE
CHAPTER CONTENT
NO.
4 DATA ANALYSIS AND INTERPRETATION
4.1 Analysis and Interpretation of the demographic 38
variables of the samples.
4.2 Analysis and Interpretation of the data related to
assessment and comparison of knowledge regarding use of 41
sanitary pads among rural and urban adolescent girls
4.3 Analysis and Interpretation of the data related to 45
assessment and comparison of attitude regarding use of
sanitary pads among rural and urban adolescent girls
4.4 Analysis and interpretation of data showing correlation 49
between knowledge and attitude among rural and urban
adolescent girls
4.5 Analysis and interpretation of data showing association 53
between knowledge of rural and urban adolescent girls and
selected demographic variables
4.6 Analysis and interpretation of data showing association 55
between attitude of rural and urban adolescent girls and
selected demographic variables
5 SUMMARY, MAJOR FINDING, DISCUSSION,
CONCLUSIONS, IMPLICATION AND
RECOMMENDATION
5.1 Summary 58
5.2 Major Findings 59
5.3 Discussion 62
5.4 Conclusion 64
5.5 Implications and Utilization 64
5.6 Recommendation 66
REFERENCES 67
APPENDICES 70-118
ABSTRACT 119
iv
LISTS OF TABLES
TABLE PAGE
CONTENT
NO. NO.
3.1 List of selected areas of research study 25

3.2 Blue Print contains number of Items on Structured Knowledge 31
Questionnaire on use of sanitary pads.
3.3 Blue print contains number of items on Likert’s Attitude Scale 32
on use of sanitary pads.
4.1.1 Frequency and Percentage wise distribution of the Demographic 38
Data.
4.2.1 Frequency and percentage wice distribution showing Knowledge 41
score regarding use of sanitary pads among rural and urban
adolescent girls
4.2.2 Mean, Median, Mode, range and Standard Deviation (SD) of the 43
knowledge scores of rural and urban adolescent girls.
4.2.3 Comparison of knowledge score of rural and urban adolescent 44
girls regarding use of sanitary pads.
4.3.1 Frequency and percentage wice distribution showing attitude 45
score regarding use of sanitary pads among rural and urban
adolescent girls.
4.3.2 Mean, Median, Mode, range and Standard Deviation (SD) of the 47
attitude scores of rural and urban adolescent girls..
4.3.3 Comparison of attitude score of rural and urban adolescent girls 48
regarding use of sanitary pads.
4.4.1 Correlation between knowledge score and attitude score among 49
rural adolescent girls.
4.4.2 Correlation between knowledge score and attitude score among 51

urban adolescent girls.
4.5.1 Association between knowledge score of rural adolescent girls 53
and selected demographic variable.
v
TABLE PAGE
CONTENT
NO. NO.
4.5.2 Association between knowledge score of urban adolescent girls 54
and selected demographic variable.
4.6.1 Association between attitude score of rural adolescent girls and 55
selected demographic variable.
4.6.2 Association between attitude score of urban adolescent girls and 56
selected demographic variable.
vi
LISTS OF FIGURES
FIGURE PAGE
CONTENT
NO. NO.
1.1 Conceptual Framework on Health Belief Model 11

3.1 Schematic representation of research design to assess the 24
Knowledge and Attitude on use of sanitary pads
3.2 Map showing Selected Schools of rural and urban areas of 26
Ahmedabad
4.1 Graph showing Frequency wise distribution of Demographic 40

Data of the Samples.
4.2 Graph Showing the Knowledge level of rural and urban 42

adolescent girls regarding use of sanitary pad
4.3 Graph Showing the Attitude score of rural and urban 46
adolescent girls regarding use of sanitary pads.
4.4 Scattered diagram showing the correlation between 50
knowledge and attitude among rural adolescent girls
regarding use of sanitary pads
4.5 Scattered diagram showing the correlation between knowledge 52

and attitude among rural adolescent girls regarding use of
sanitary pads
vii
LISTS OF APPENDIX
PAGE
APPENDIX CONTENT
NO.
A Research Tool on Use of sanitary pads 71

B Letter seeking permission for conducting pilot study in 87
rural area school
C Letter seeking permission for conducting pilot study in 88
urban area school
D Letter seeking permission for conducting main study in 89
rural area schools
E Letter seeking permission for conducting main study in 91
urban area schools
F Certificate of Statistician 93
G Certificate of Gujarati Editing 94

H Certificate of English Editing 95
I Data Collection plan 96
J List of tool Validators 97

K Master data sheet of Demographic variables 98
L Master data Sheet of Knowledge Score 103
M Master data Sheet of Attitude Score 112
viii
CHAPTER- I
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
“Investing in yourself is the best investment you will ever make”
-J B WEST.
The knowledge of perception and behaviour on the use of sanitary pads during
menstruation among adolescents of school age is a vital aspect of health education.
Menstruation still regarded as something unclean or dirty in Indian society, related
with misconceptions and cultural restrictions. Lack of knowledge and poor hygienic
practices during menstruation can lead to various gynaecological problems in the
reproductive life of girls. Rajanbir Kaur, Kanwaljit Kaur.(2018)
Poor menstrual hygiene causes great impact in increased vulnerability to
reproductive tract infections (RTI). Currently millions of women sufferers from RTI
and infection is transmitted to the offspring. Women having knowledge regarding
menstrual hygiene are less vulnerable to RTI and its consequences. Therefore,
increased knowledge about menstruation from adolescent period help in decreased
suffering of millions of women. Various studies indicate that a huge information gap
exists among rural and urban adolescent girls regarding menstrual hygiene.
When the girl attains menarche, menstrual hygiene is the real challenge for
them to practice. The good menstrual hygiene prevents reproductive tract infection
among girls which ultimately promote the reproductive health. The current trend of
antenatal care starts from puberty. This concept was emphasized by Kumari (2014)
who conducted a study among girls regarding menstrual hygiene revealed that only
few girls were using sanitary napkin and many did not practice the same. Menstrual
hygiene involves the personal hygiene measures to be adopted by women and
adolescent girls, it includes the use of clean material to absorb or collect menstrual
blood and these materials can be changed in privacy as often as necessary for the
duration of menstruation. Menstrual hygiene management also includes, using soap
and water for washing the body as required and having access to facilities to dispose
of used menstrual management material. To highlight the menstrual hygiene
awareness among girls 28th May is observed as menstrual hygiene day, which aims to
break taboos and raise awareness about the importance of good menstrual hygiene
management for women and adolescent girls worldwide. Kumari (2014)
1
Sanitary pad or menstrual pad is an absorbent item worn by women who are
menstruating, bleeding after giving birth, recovery from gynaecological surgery, or
any other situation where it is necessary to absorb a flow of blood from vagina.
Through the ages women have used different forms of menstrual protection.
Menstruation and menstrual practices still face many social, cultural, and
religious restrictions which are a big barrier in the path of menstrual hygiene
management. In many parts of the country especially in rural areas girls are not
prepared and aware about menstruation so they face many difficulties and challenges
at home, schools, and work places. While reviewing literature, we found that little,
inaccurate, or incomplete knowledge about menstruation is a great hindrance in the
path of personal and menstrual hygiene management. Girls and women have very less
or no knowledge about reproductive tract infections caused due to ignorance of
personal hygiene during menstruation time. In rural areas, women do not have access
to sanitary products or they know very little about the types and method of using them
or are unable to afford such products due to high cost. So, they mostly rely on
reusable cloth pads which they wash and use again. Needs and requirements of the
adolescent girls and women are ignored despite the fact that there are major
developments in the area of water and sanitation. Women manage menstruation
decently when they are at home or outside; at homes, they dispose of menstrual
products in domestic wastes and in public toilets and they flush them in the toilets
without knowing the consequences of choking. So, there should be a need to educate
and make them aware about the environmental pollution and health hazards
associated with them. Implementation of modern techniques like incineration can help
to reduce the waste. Also, awareness should be created to emphasize the use of
reusable sanitary products or the natural sanitary products made from materials like
banana fiber, bamboo fiber, sea sponges, water hyacinth, and so on. Rajanbir Kaur,
Kanwaljit Kaur.(2018)
In under developed countries, reusable or makeshift pads are still used to
collect menstrual blood. Rags, soil, and mud are also reportedly used for collecting
menstrual flow. In order to meet the need for achieving am inexpensive solution to
reduce unsanitary & unhygienic practices in countries like India, Arunachalam
Muruganantham from rural Coimbatore in the southern state of Tamil Nadu, India
developed and patented a machine which could manufacture low cost sanitary pads
for less than a third of former cost.
2
The study was carried out among 140 school girls. It investigated perception
as well as behaviour on the use of sanitary pads during menstruation. Specific
objectives were tailored to determine adolescent girls’ perception on the use of
sanitary pads during menstruation and also to assess their behaviour on using sanitary
pads for menstrual hygiene. Girls were selected by cross sectional population survey
of educational institutions. 56 from primary school and 84 from junior secondary
school within the age group of 10-20 years were given questionnaire to gather data for
analysis. The results show that of the 140 girls studied, 64.3% of girls used sanitary
pads with prevent infectious diseases as well as to bridge the gap with the training at
home by mothers and other sources of infections. More than half of the girls from an
urban area were using sanitary napkins, whereas in a rural area significantly less
number of girls (29%) were doing so.Similar kind of observations have been made by
many other studies.Contrasting findings have also been reported by many studies.In
this study, 84.3% of the girls were reusing cloth after washing, which is quite higher
than the findings reported by other authors.Most of them (93.5%) were reusing it after
washing with soap and water. Similar findings have been reported by investigator.
Only 47% of girls in an urban area and around one-third girls in a rural area had a
good practice of drying the washed cloth in sunlight. This is higher than the findings
of Patle.(2014)but lower than the findings of other studies. Sarkar M (2018)
Many gynecologists believe that sanitary napkin can act as a precautionary
measure to prevent reproductive tract infection. The sanitary napkin is one of the
appropriate measures to be practiced by school girls during the time of menstruation.
This is substantiated by the finding of Jimmy Wales (2013) et.al., which highlighted
that sanitary napkins prevent reproductive tract infection and reduce the risk of
cervical cancer. The Role of community health nurse in school health is important. It
comprises imparting knowledge to the school girls about the importance of sanitary
napkin and promote the menstrual hygiene practices. When the school girl is educated
she propagates the information to her family members, friends and to the society. She
also influences her friends to practice good menstrual hygienic measures. It promotes
the dignity of the girls and women in the society. Thus the community health nurse
play an major role to empower the school girls with adequate knowledge on sanitary
napkin during menstruation, which enhances self esteem and academic performance.
Therefore It helps them to develop themselves comprehensively and that promote
their quality of life. Jimmy Wales (2013) et.al.
3
1.2.NEED FOR STUDY
Menstruation is part of female reproductive cycle that starts when girls
become sexually mature at the time of puberty. The menstrual period lasts from 3-7
days. During these periods if girls not maintain proper hygiene it may affects
reproductive system. There are some differences are present related to awareness
regarding using hygienic practices among adolescent girls of rural and urban areas.
Due to lack of knowledge and improper use of sanitary napkins may cause harmful
effects for the girls reproductive age.
“Only 12% of India’s 355 million menstruating women use sanitary napkins.
Over 88% of women resort to shocking alternatives like un sanitized clothes, ashes
and husk sand. Incidents of reproductive tract infections is 70% more common among
these women.” This findings from a study in October 2011 by The Neilson Company
and NGO Plan India, has been quoted in almost every write up about menstruation in
India.
According to National Family Health Survey (NFHS) report 2017,
published in only 58 percent of women in India aged 15 to 24 use a hygienic method
of menstrual protection, the Hindu daily reported.
The National Family Health Survey (NFHS) 2015-2016 report shows that
the use of sanitary pads among Indian women is 48.5% in rural, 77.5% in urban and
57.6% total. Regarding school absenteeism owing to menstruation 17% teenagers in
Canada, 21% in Washington, 24% in Singapore, 26% in Australia and 24% in India.
A cross-sectional study on Awareness Regarding Safe and Hygienic Practices
among school girls in rural area of Maharasthra in India. A sample of 300 girls who
were in the age of 10 - 19 years and who had attained menarche were randomly
selected. The findings of the study reveals that 40.67 percent of the girls received
information about menstruation from their mothers; 46.67 percent of girls used old
cloths during menstruation and only 15.67 percent were using sanitary napkins.
Cleaning of external genitalia was not satisfactory. Only 56.57 percent girls disposed
the used cloth pieces or sanitary napkins. Mudey et al (2010)
According to Kamath R (2013) Around 34% participants were aware about
menstruation prior to menarche and mothers were the main source of information
among the groups. Overall , 70.4% of adolescent girls were using sanitary napkins as
menstrual absorbent, while 25.6% were using both cloth and sanitary napkins. Almost
4
half of the rural participants dried the absorbents inside the homes. Conclusion: there
is a need to equip the adolescent girls with knowledge regarding safe, hygiene
practice to enable them to lead a healthy reproductive life. Kamath R (2013)
A Study Conducted for compare the practices of urban and rural school going
adolescent girls regarding menstrual hygiene. It was a descriptive cross sectional
study carried out in Government and private schools located in the areas served by
UHTC and RHTC of Department of Community Medicine, SRMS IMS, Bareilly
(UP). Adolescent girls studying in 6thto 10thclass in selected schools comprised the
study population. Inclusion criteria were adolescent girls aged 10–19 years who had
attained menarche and were studying in 6th to 10th class in the selected schools.
Three fourth 142 (75.5%) of rural girls were following restrictions during menses as
compared to less number of urban subjects 126 (71.6%). The most common
restriction followed was not attending religious function as practiced by 73.9% and
66.7% of rural and urban girls respectively. Study on the use of material during
menses revealed that the use of sanitary pads was more common among urban
adolescent girls (62.5%) compared to rural (35.1%). Most common reason cited for
not using sanitary pad was high cost as reported by 42.6% and 43.9% of rural and
urban girls respectively. Overall menstrual practices were better in urban as compared
to rural girls. Priyanka Kumar*, S.B. Gupta, ImtiazDanish(2016)
According to World Health Organization (2015) there are about 74% of
school girls had suffered with reproductive tract infection due to improper
menstrualhygiene. The poor menstrual hygienic practices also leads to several
problem among school girls which include dropped out from the school, inability to
continue the education and reduction of self-esteem. It occurs because the school girls
don’t practice menstrual hygiene and don’t have accessibility for sanitary napkin.
The biggest barrier to adopt the quality of sanitary napkin in India are lack of
affordability and accessibility as reported by Inderjeet Singh (2013) there are about
70% of school girls and their the family cannot affords sanitary napkin. It is further
supported by the report of Times of India (2014) which unveiled that 50% of the
school girls who dropped out the school in secondary classes are due to lack of
sanitary napkin, coupled with lack of separate toilet facilities and water resources
within the school campus. Thus the lack of knowledge on menstrual hygiene practice
and sanitary napkin are the major cause for absenteeism among school girls.
5
Another major factor that is to be considered among school girls is early
menarche, which is the growing trend across Globe especially in urban areas. Since
many school girls attain menarche between 12 to 14 years they don’t have adequate
knowledge about the onset of menstruation, physical and physiologically
development. In addition to their early puberty may cause emotional pressure among
school girls which may reduce their academic performance. The study was conducted
by EsrealAyele et.al. (2015) revealed that the yearly menarche is a major cause for
poor menstrual hygienic practices.
A study was conducted by Dr.Neelam Singh, Rierdan (2013) have reported
that school students don’t have adequate knowledge and practice on menstrual
hygiene. Further Rierdan (2013) concluded that only 40.6% of girls have knowledge
regarding menstruation and among them only 12.9% of school girls practice the same.
Thus these findings paved the way for the investigator to impart knowledge regarding
sanitary napkin during menstruation, thereby to enhance the practice of menstrual
hygiene.
On the basis of the above information it is concluded that the knowledge of
school girls on use of sanitary pads is inadequate and the adolescent girls are still
ignorant of the scientific fact on menstrual hygiene health practices, which may cause
adverse health outcomes. These underlines the role of the community health nurse and
also emphasize the need to assess the knowledge and expressed practice regarding
sanitary pads which is used during menstruation by the school girls who attained
menarche. This has motivated the investigator to conduct a Comparative study to
assess the knowledge and attitude regarding use of sanitary pads among adolescent
girls studying in selected schools of rural and urban areas of Ahmedabad.
1.3 PROBLEM STATEMENT:
AND URBAN AREAS OF
AHMEDABAD
6
1.4 OBJECTIVES OF THE STUDY:-
1. To assess and compare the knowledge regarding Use of sanitary pads among the
adolescent girls studying in selected schools of rural and urban areas of
Ahmadabad.
2. To assess and compare the attitude regarding Use of sanitary pads among the
Ahmadabad.
3. To find out the correlation between the knowledge and attitude regarding Use of
sanitary pads among the adolescent girls studying in selected schools of rural and
urban areas of Ahmadabad.
4. To find out the association between selected demographic variables and
knowledge regarding Use of sanitary pads among the adolescent girls studying in
selected schools of rural and urban areas of Ahmadabad.
5. To find out the association between selected demographic variables and attitude
regarding Use of sanitary pads among the adolescent girls studying in selected
schools of rural and urban areas of Ahmadabad.
1.5. ASSUMPTIONS OF STUDY:-
1. There will be good knowledge among adolescents girls studying in selected
schools of urban areas than rural areas regarding use of sanitary pads among
adolescents girls studying in selected schools of rural and the urban areas of
Ahmadabad.
2. There will be positive attitude among adolescents girls studying in selected
Ahmadabad.
3. There will be significant correlation between knowledge score and attitude score
regarding use of sanitary pads among adolescents girls studying in selected
schools of rural and the urban areas of Ahmadabad.
4. There will be significant association between selected demographic variable and
adolescents girls knowledge regarding use of sanitary pads among adolescents
girls studying in selected schools of rural and the urban areas of Ahmadabad.
7
5. There will be significant association between selected demographic variable and
adolescents girl attitude regarding use of sanitary pads among adolescents girls
studying in selected schools of rural and the urban areas of Ahmadabad.
1.6. OPERATIONAL DEFINATIONS:
1 COMPARATIVE STUDY:
Comparing study means comparing two or more variable by observing their
performance or activity. In this study the investigator wanted to compare the
knowledge and attitude regarding the use of sanitary pad among adolescent girls
in the selected school of rural and urban area of Ahmedabad.
2 ASSESS:
It refers to process to identify knowledge and attitude regarding use of sanitary
pads among adolescent girls in the selected school of rural and urban area of
Ahmedabad.
3 KNOWLEDGE:
It refers to the understanding or having the information regarding the use of
sanitary pads among adolescent girls.
4 ATTITUDE:
It refers to the behaviour or thought exhibited by the rural and urban girls towards
sanitary pads.
5 SANITARY PAD:
A disposable absorbent pad used during menstruation to absorb the uterine blood
flow.
6 ADOLESCENT GIRLS:
In this study it refers to girls who have attained menarche between 11-18 years of
age.
7 RURAL AREA:
It is the geographical area that is located outside the cities.
8 URBAN AREA:
It is defined as a having populated group living in the cities in an urban areas.
1.7. DELIMITATION:
The study is delimited to:
 Adolescent girls age between 11 years to 18 years of age.
8
 “200” adolescent girls of selected schools of rural and urban area of
Ahmedabad.
1.8. CONCEPTUAL FRAMEWORK
Conceptual framework is the schematic representation of the study. It provides

theoretical approach to the study of the problem that is scientifically based and lay
emphasize on the selection, arrangement and clarification of concepts. It is a device
for organizing ideas and in turn bringing order to related objects, observation, events
and experiences. It serves as a guide for generation of research hypothesis. ( Polit&
Hungler, 2006).
The conceptual model is a general amalgam of all the related concepts in the
problem area and provides certain frame of reference for the researchers. The
conceptual frame work represents a less formal attempt at organizing a phenomenon
conceptual model deal with concepts that are used a building blocks and provide a
conceptual perspective regarding interrelated phenomena which are closely
structured. (Polite, D.F. and Beck, C.T. (2010).
A conceptual framework is a network of interrelated concepts that provide a
structure of organizing and describing the phenomena of interest research study are
based on a theoretical on conceptual frame work the facilitate visualizing the problem
and place the variable in a logical contest.
Conceptual framework is the theoretical structure of assumption, principles &
rules that hold together the ideas comprising a board concept. The developed on the
basis of either theories or assumption that beliefs pertaining to the subject concerned.
The conceptual model is a schematic presentation of a theory. It provides a certain
frame of reference for clinical practice, research and education. The conceptual
framework for study is based on modified health belief model (Rosentoch’s&
Backers &Maiman’s 1975)
The main components of model are:
(1) Individual perception
(2) Modified factors
(3) Likelihood of taking action
9
1) Individual perception includes:
 Perceived utilization of sanitary pad which are provided by family,
friends, schools, or purchased by own self.
2) Modified factors:-
 Modified factors are the demographic variables of the samples.
Following are the demographic variables in this study
 Demographic variables:
(Age, Education, Attainment of menarche, Source of information,
Attended any programme related to Use of Sanitary Pads?)
3) Likelihood of taking action:-
 Assessment of utilization of sanitary pad among adolescent girls.
 Creating awareness among adolescent girls related to use of sanitary
pads.
10
Individual Modifying factor Likelihood of
GOVT. HOSPITAL FOR MENTAL HEALTH, GUJARAT STATE

SCHOOLS OF RURAL AND URBAN AREA , AHMEDABAD
perception action
SCHOOLS OF RURAL AND URBAN AREA , AHMEDABAD

Comparative Study to assess the -Development of Compare the Knowledge and
knowledge and attitude regarding attitude of adolescent girls
Structured knowledge
the use of Sanitary pads among studying in selected schools of
Questionnaire and Likert’s
adolescent girls studying in rural and urban areas
Attitude Scale regarding
selected schools of rural and urban
use of Sanitary pads
areas of Ahmedabad.
-Demographic Variables:- -Administration of

Structured knowledge
 Age Questionnaire and Likert’s Lack of Knowledge Regarding
 Education Attitude scale Use of Sanitary pads
 Attainment of Menarche
 Sources of information -Analysis of Statistical
 Attended any data
programme related to
Use of Sanitary Pads?
Clues of Action
Oral health education regarding
use of sanitary pads
Figure-1.1:Conceptual framework based on Health Belief Bodel (Rosen stock’sand Beckers’s)
11
CHAPTER - II
REVIEW OF LITERATURE
The word "literature", for a piece of research the meaning is more specific. In
terms of a literature review, "the literature" means the works you consulted in order to
understand and investigate your research problem. One of the most important early
steps in a research project is conducting literature review. A well-structured literature
review is characterized by a logical flow of ideas; current and relevant references with
consistent, appropriate referencing style; proper use of terminology; and an unbiased
and comprehensive view of the previous research on the topic. A literature review is a
body of text that aims to review the critical points of current knowledge and or
methodological approaches on a particular topic.
The major goal of the review of literature is to develop a strong knowledge
base to carry out research and non- research scholarly activities in educational and
clinical practice settings.
The review of Literature is defined as a broad, comprehensive in-depth,
systematic and critical review of scholarly publications, unpublished scholarly print
materials, audiovisual materials and personal communications.”
Polit, D.F. and Beck, C.T. (2010) stated that, a review of related literature
refers to activities involved in identifying and searching for information on a topic
and developing an understanding of the state of knowledge on that topic as well as to
the actual written summary of the state of art on a research process.
The Investigator did an extensive review of the research and non-research
literature related to the present study and attempt was made through MEDLAR and
INTERNATE search. This contributed to a deeper insight in to problem area,
methodology, construction of tool and analysis of data.
Keeping this point in mind investigator has made an attempt to review the
available literature, published and unpublished research thesis on the problem.
The literature was collected extensively and organized under the following
headings.
2.1. Literature related to the menstrual hygiene among school girls.
2.2. Literature related to knowledge and attitude regarding use of sanitary pads
among adolescents girls.
12
2.1. Literature related to the menstrual hygiene among school girls
Priyanka Kumar*, S.B. Gupta, Imtiaz Danish(2018) A Study Conducted for

compare the practices of urban and rural school going adolescent girls regarding
menstrual hygiene. It was a descriptive cross sectional study carried out in
Government and private schools located in the areas served by UHTC and RHTC of
Department of Community Medicine, SRMS IMS, Bareilly (UP). Adolescent girls
studying in 6th to 10th class in selected schools comprised the study population.
Inclusion criteria were adolescent girls aged 10–19 years who had attained menarche
and were studying in 6th to 10th class in the selected schools. Three fourth 142
(75.5%) of rural girls were following restrictions during menses as compared to less
number of urban subjects 126 (71.6%). The most common restriction followed was
not attending religious function as practiced by 73.9% and 66.7% of rural and urban
girls respectively. Study on the use of material during menses revealed that the use of
sanitary pads was more common among urban adolescent girls (62.5%) compared to
rural (35.1%). Most common reason cited for not using sanitary pad was high cost as
reported by 42.6% and 43.9% of rural and urban girls respectively. Overall menstrual
practices were better in urban as compared to rural girls.
Vasanthi R, and Manju Bala Dash(2018) A study conducted on “Are Maintaining

Menstrual Hygiene and usage of Sanitary Napkin being Important for Adolescent
Girls? A descriptive study was conducted among adolescent girls in selected college
at Puducherry. Sample size was 100, selected through purposive sampling. The
approach used was Quantitative approach and design was descriptive design.
Researcher made questionnaire contained three sections i.e., demographic variables,
questions related to practice during menstruation and usage of sanitary napkin
respectively. The major findings of the study, 19% had Poor practice regarding
menstrual hygiene, 66% had Moderate practice whereas 15% had Good practice
regarding menstrual hygiene. Regarding menstrual bleeding management, 98% of
them was using sanitary napkin whereas 2% of them using clothes to absorb during
menstruation. Among the samples, 99% of them getting napkin from their own
expense whereas 1% was using government free supply napkin. Regarding cost, 64%
of them were purchasing napkin between 20 and 40 rupees, 27% of them was
purchasing between 40 and 60 rupees, 8% of them was purchasing above 60 rupees.
13
Praveen gautam, Nirmal Kiron (2018) Study of menstrual hygienic practices and
reproductive tract infection among the adolescents girls. It was a cross sectional study
conducted on 200 adolesent girls, objective of the study was to know the level of
knowledge, attitude and practices during menstruation and RTI among the
adolescents girls. Result was The study reported that majority of the girls attained
menarche at the age of 13 yrs (51%), and Sanitary pads usage during menstruation
was seen in (97%) and Mother was the source of information about menstruation
before menarche for most of them. Proper knowledge, attitude and hygienic practices
in menstruation are not seen among the study participants , for whom a suitable
planned health education needed. Early awareness can prevent students from suffering
from the various reproductive tract infections.
Pradeep Senapathi, Hemant Kumar (2017) A comparative study of menstrual

hygiene management among rural and urban adolescent girls. It was cross sectional
study carried out in mangaluru, Karnataka. A total of 244 adolescent school girls
participated in this study. Out of these, 54.17% girls were from rural, while 45.83%
were from the urban school. Mean age of menarche of all the respondents was
12.61±0.81 years. Overall, 69.67% girls were aware of menstruation prior to
attainment of menarche. The awareness was found to be more among urban school
girls (72.32%) as compared to rural girls (67.42%). The study brings out that 49.24%
of the girls in the rural school and 65.17% of the girls in urban school were using
sanitary pads. ‘High cost’ was cited as the main reason for not using the sanitary
pads. Menstrual hygiene management was found to be sub-optimal among both, urban
as well as rural Adolescent girls.
Khyrunnisa (2015) conducted a community based cross sectional study among 251
school girls in the Gazipur village in East Delhi, to help identify and overcome
barriers to proper hygiene practice through door to door survey, the age menarche was
13-16 years, only 41.1% girls had knowledge about menstrual hygiene practice, rest
of the girls had inadequate knowledge regarding menstrual practice. The study
concluded that education about menstrual hygiene is vital aspect in improving the
health.
14
Baishakhi paria, Agnihotri Bhattacharya and Sukes Das(2014) A Comparative
Study on Menstrual Hygiene Among Urban and Rural Adolescent Girls, A
community-based cross-sectional study was conducted from April 2014 to September
2014 in urban and rural area of South 24, Paraganas, West Bengal among 541
adolescent school girls in the age group of 13–18 years. Data were collected by the
predesigned and pretested questionnaires. Only 37.52% girls were aware of
menstruation prior to attainment of menarche. The difference in the awareness
regarding menstruation in urban and rural area was highly significant. Only 36% girls
in the urban and 54.88% girls in the rural area used homemade sanitary pads and
reused the same in the subsequent period. Satisfactory Cleaning of external genitalia
was practiced by only 47.63% of the urban and 37.96% of the rural girls. This study
found differences in hygienic practices followed by adolescent girls in urban and rural
area. Hygienic practices during menstruation were unsatisfactory in the rural area as
compared to the urban area.
Grag R, et.al., (2014) conducted a study on issue and challenges regarding subsidized
sanitary napkins for rural school girls. In India menstruation is surrounded by myths,
and misconceptions with a long list of “do’s” and “don’ts” for women. Poor menstrual
hygiene is one of the major reasons for the high prevalence of RTIs in the country and
contributes significantly to female morbidity. The government of India proposed a
new scheme towards menstrual hygiene by a provision of subsidized sanitary napkins
to rural school girls. But there are various other issues like awareness, availability and
quality of napkins regular supply, privacy and water supply, disposal of napkins,
reproductive health education and family support which needs simultaneous attraction
for promotion of menstrual hygiene.
Annal Angeline (2013) conducted a cross –sectional study among 251 adolescent
girls in the Gazipur village in east Delhi through door to door survey. A study is
performed by a cluster randomized method. The study results showed that the mean
age of menarche was 13.6 years. 29% subjects said that they had prior knowledge
regarding menstruation mothers 41% were the most common source of information,
while 92% of girls said they were restricted from worshipping 70% restricted from
household activities 74.8% of the girls used sanitary pads. The study findings stressed
the need to improve the menstrual hygiene and sanitary napkin practices.
15
Aparajita (2013) conducted cross sectional study on menstrual hygiene in rural
Thiruvanthapuram, Kerala. The majority 60.8% death with menstruation in
unhygienic way and a significant association was seen between menstrual hygiene
maintenance and education symptoms suggestive of reproductive tract infection. The
study results reported that 36.1% of the subjects had stain problems related to sanitary
protections, 45.8% of the women hygienic management of menstruation. There was a
statistically significant reproductive tract infection and skin problems with sanitary
protection, among school girls.
Drakshyani Devi (2012) conducted a prospective study on menstruation in school

girls in Singur. The sample size were 12 school girls were randomly recruited into the
study The study findings revealed that 10% girls received advice regarding menstrual
hygiene from different source, some of their practices were unhygienic so that the
girls should be educated about the significance of menstruation absorbent and its
proper disposal of sanitary napkin.
2.2. Literature related to knowledge and attitude regarding use of

sanitary pads among adolescents girls.
Shekhar Chauhan, Pradeep kumar (2020) A study conducted over Examining the
predictors of use of sanitary napkins among adolescent girls: A multi-level approach
The study uses information from the Understanding the Lives of Adolescents and
Young Adults (UDAYA) project survey conducted in Uttar Pradesh and Bihar in
2016. The study sample consisted of 14,625 adolescent girls aged 10–19 years. The
study sample was selected using a multi-stage systematic sampling design. Multilevel
logistic regression (MLR) was used to identify the individual and community level
factors associated with the use of sanitary napkins. The results revealed a wide
variation in sanitary napkins’ use across the socio-economic and demographic factors.
The use of sanitary napkins was significantly higher among girls with 8–9 (53.2%)
and 10 and more (75.4%) years of schooling compared to those who had no formal
education (26.4%). The use of sanitary napkins was higher among adolescent girls
who were not engaged in paid work (54.7%) than those who did any paid job (40.8%).
Adolescent girls reporting frequent exposure to mass media (OR = 2.10), belonging to
the richest wealth quintile (OR = 3.76), and whose mothers had 10 or more years of
education (OR = 2.29) had a higher propensity to use sanitary napkins than their
16
counterparts. We did not find a significant role of community-level education of
mothers on the menstrual hygiene practices of adolescents.
Pooja Arugula, Suresh Kumar Paramasivam, Niharika Kanuri(2017) A study

conducted on Perception on Use of Sanitary Napkins Among Students in Khammam
Locality: a Survey. The study was carry out our studies we started our work on
November 2016 and completed by April 2017 during which we provided each student
(around 500 students of age group 11-20 and 21-30) with a printed copy comprising
of various queries regarding sanitary napkins. Based on the obtained data we found
that, in students of both the age groups majority of the students are rarely
experiencing discomfort, rashes (47.55% on average), majority of the students are not
satisfied with the price (59.25% on average), most of the students are not at all having
any idea about the chemicals used in sanitary napkins (57.29% on average), majority
of students change their sanitary napkins at a time interval of 4-8 h (46.7% on
average) and majority of students consider various factors like comfort, quality, price,
size, package (37.75% on average) while choosing a sanitary napkin. Finally, we
found out that most of the students are not satisfied with the price of the sanitary
napkins and even they are not aware of the chemicals that are being used in the
manufacturing of the sanitary napkins.
Danker (2015) did a study to assess the knowledge and practice of menstrual practice
among school girls aged between 10 to 15 years in Nigeria this is a school based cross
sectional descriptive study conducted from September 2014 to February 2015 among
school girls in Nigeria selected by multistage sampling technique. The study findings
showed that 50% of the girls had lack of knowledge about the origin of menstrual
blood and 50% of the participants reported that they did not take bath during
menstruation. The study results concluded that most of the girls were unaware of
hygienic practice and misconceptions about menstruation.
Lee (2015) carried out descriptive cross – sectional study about menstrual practice,
the prevalence of proper menstrual practice and related factors among sixth grade of
elementary students in Guntur, Karnataka district. A self-administered questionnaire
was administered to 274 students at seven schools randomly selected by proportion to
size from five villages. Data was analyzed using descriptive statistics. The study
17
results concluded that they had adequate knowledge about menstruation, most of them
used sanitary pad as absorbent during their last menses changed menstrual dressing
about 1-5 times per day and three quarter increased the frequency of bathing.
Adhikari P.et.al., (2015) conducted a study to evaluate the knowledge and practice
on different aspects of menstrual hygiene. One hundred and fifty school girls of age
13-15 years from 3 school of Shivanagar and Patihami Village development
committees of Chitwan district were involved in this study. Ninety four percentages
of them use the pads during the period. The study results revealed that overall
knowledge and practice about the use of sanitary napkins were increased among
school girls.
Lynette (2014) conducted a cross sectional study about knowledge on menstruation

among school girls in Jordanian. The sample of the study was 40 of aged between 13-
17 years and also suggested that schools and teachers should be reinforced through
and well planned health educators for girls and their mothers to improve menstrual
hygiene and napkin practice. The study results found that there was a adequate
knowledge toward menstruation and menstrual practices.
Carol Dashiff (2014) conducted a descriptive study to find out the knowledge on
menstrual hygiene among school girls in urban Karachi, Pakistan. A total sample of
263 girls through randomized technique The study results proved that first informant
regarding menstruation out of 37.5% girls, 86.25% girls believed it was a
physiological process, 48.75% girls know the use of sanitary pad during
menstruations regarding practices only 11.25% girls used sanitary pads during
menstruation. The study concluded and suggested that menstrual practice promotion
to improve child well – being and societal productivity.
Soeffer et.al. (2014) conducted a descriptive qualitative study on menstrual health

among school Girls, at Eijaur. The sample size was 150 school girls. Through random
sampling menstrual practice was assessed. The study revealed that inaddition to
medical problems, the blind girls had difficulties in maintaining personal hygiene,
especially during menstrual period 100% blind girls were following poor hygienic
practices during menstruation and 15% were using sanitary pads.
18
Deshmukh P.R et.al., (2014) conducted a study on the effect of community based
health education intervention on awareness and behavior change of rural adolescent
girls regarding their management of menstrual hygiene at primary health Centre in 23
villages in the warthog district of Maharashtra state. Study subjects were unmarried
rural adolescent’s girl (12-19 years).The study target audience using a triangulated
research design of quantitative (survey) and qualitative (Focus group discussion)
method. After 3 years, significantly more ad descent girls (55%) were aware of
menstruation before its initiation compared with baseline (35%) the practice of using
readymade pads increased significantly from 57 to 85% the study results showed that
adolescent girls perceived a positive change in their behavior and level of awareness.
Rao R.S.P et.al., (2014) conducted a study on effectiveness of reproductive health

education among school girls in Karnataka.” The objective is to determine the
effectiveness of an educational intervention program on knowledge of reproductive
health among adolescent girls chi square test was used to test the effect of the
intervention. A significant increase in overall knowledge after the intervention (from
14.4 to 68% p<0.0001) The study results suggested that an educational intervention
programme can bring about a desirable change in knowledge among school girls
regarding reproductive health..
Subhash B, Thakre et. al., (2013) conducted a experimental study do assess the
knowledge and the practices of menstrual hygiene among 387 rural elementary school
girls, in Denmark. The present study was undertaken among school girls selected by
simple random sampling. The study results showed that 36-95% of the girls were
aware of menstruation. A majority of them had knowledge about the use of sanitary
pads. The mean age of menarche of study subjects was 12.85+ 0.867 years, sanitary
pads were used by 49.35% of the selected girls. The study results concluded that
menstrual hygiene indices have shown a significant difference in the rural and urban
girls.
Nair M.K. et. al., (2013) conducted a experimental study on menstrual hygiene
practices in school girls in Thiruvananthapuram, the aim of the study was to evaluate
and intervention to reduce student absenteeism through increase menstrual practice.
The experimental school included 341 pupils aged between 10 to 15 years. the method
used were cluster randomized trial of a hygiene promotion among school girls the
19
study revealed that 72.4% school girls used sanitary protection during menstruation.
Menstrual hygiene was adequate in the majority of girls, menstruation are common in
school girls and have significant consequence on future health.
Rose J.G.(2013) conducted a study on Attitude toward and experience with

menstruation in the USA and India, Sixty seven women students who were attending
a university in southern India and 61 women students who were attending a liberal
Girls college in new England Volunteered to participate in this study. The study
results showed that Indian women scored significantly higher than American women
on the attitude sub scale.
A.J.Singh (2013) conducted a qualitative and quantitative study on reproductive

health of Indian women in two primary health Centre areas of rural North India. A
study sample comprised of 669 women. Data consisted of menstrual hygiene and
knowledge about sanitary practice. The results of the study stated that approximately
72% of women used sanitary napkin during menstruation. Women were classified as
having adequate knowledge of proper menstrual practice. The study revealed that the
women in primary health Centre exhibited sustained improvement in hygienic
knowledge and decreased risk of RTI and UTI infection.
Shazly et.al.,(2013) conducted a study to assess the knowledge on menstruation and

menstruation and menstrual hygiene practices among nursing students affiliated to
university of Alexandria The study sample size include all secondary school nursing
students enrolled in main university, Hospital, Structured interview, Questionnaire
were based on age of menarche length of menstrual cycle and duration of menstrual
flow, menstrual practice such as change of sanitary pad per day, bathing , washing
hands after handling sanitary pad. The study results showed that ¼th of sample avoid
taking bath during menstrual period 2/3rd of them stated that they used 3-8 sanitary
pads per day. ¾th washed hands after handling sanitary pad.
Rajashree R. Kamble (2012) conducted a study to evaluate school – based hygiene

and water treatment programs to increase student knowledge, improve hygiene and
decreased as absenteeism. Baseline information was collected from students in 42
schools in Kenya. The study findings showed that 61.66% of the girls had an average
knowledge regarding menstruation on menstrual hygiene and 87.66% of the girls
20
followed correct practices. The students in this school program improve the menstrual
hygiene and napkin practice.
SUMMARY
From the above research literature I got to know that use of sanitary pads knowledge
among adolescents girls is more necessary in India. The need of the hour is to
educate and teach adolescents girls and create awareness among the adolescents girls
regarding use of sanitary pads. So I had decided to compare the knowledge and
attitude among adolescents girls studying in rural and urban areas about use of
sanitary pads.
21
CHAPTER-III
RESEARCH METHODOLOGY
Methodology includes research approach and its rationale, description of setting
and population, sampling technique, sample population, discrimination of sample,
tools selection, and construction, discrimination and rationale procedure of data
collection, data analysis, statistically method used.
The methodology of research indicate general pattern of organizing that procedure
for gathering valid and reliable data for the purpose of investigation. This chapter
deals with the description of method and different steps used for collecting and
organizing data. It include the research design, research approach, setting, sample and
sampling techniques, development and description of tool, development of teaching
strategy, pilot study, data collection procedure and plan for data analysis.
The study was conducted on “A Comparative study to assess the knowledge and
attitude regarding use of sanitary pads among adolescents girls studying in selected
schools of rural and urban areas of Ahmedabad”.
3.1 SELECTION OF RESEARCH APPROCH
A research approach tells the researcher as to what data to be collect and how to
analyze them. It also suggests possible conclusion to be drawn from the data.
Research approaches refers to the overall plan for obtaining answers to the research
questions and for testing the assumption. ( Polit,D.F. and back, C.T.,1995)
The approach tells the basic procedure for the conduct of research inquiry. In the
present study, evaluative research approach was taken as it is appropriate whenever
the research question tests the knowledge of the people. In the analysis of data the
difference between the initial and terminal measurement represent the effect of the
independent variable.
According to pilot Hungier (1999) research approach refers to the overall plan
for obtaining answer to the research to the research question and for testing the
assumption.
Basavanthappa B.T (2007) In this approach the researcher seeks to answer the
research question through a data gathering the process with enable to describe the
present study more clearly and adequately.
Research approach indicates the basic procedure for conducting research. A
comparative survey approach was use in the study to “Compare the knowledge and
22
attitude regarding use of sanitary pads among adolescent girls studying in selected
schools of urban and rural areas of Ahmedabad”.
According to Polit D.F ,and Beck, C.T. (2004) a survey is designed to obtain
information about the prevalence, distribution, and interrelation s of variables within a
population. The investigator used comparative survey research design, in view of the
objective of this study “to assess the knowledge and attitude regarding use of sanitary
pads among adolescent girls studying in selected schools of urban and rural areas of
Ahmedabad”. This approach helped in gathering data that were most beneficial in the
fulfilling the objectives of this study.
According to Glass & Hopkins (1984) descriptive research can be either
quantitative or qualitative. It can involve collections of quantities information that can
be tabulated along a continuum in numerical form, such as scores on a test or the
number of times a person chooses to use a certain feature of a multimedia programme,
or it can describe events and the organizes, tabulates, depicts, and describe data
collection.
The present study aim is to “Compare the knowledge and attitude regarding use of
sanitary pads among adolescents girls studying in selected schools of rural and urban
areas of Ahmedabad”.
Rationale:-
A Comparative survey has used in the study to “Compare the knowledge and
attitude regarding use of sanitary pads among adolescent girls studying in selected
schools of urban and rural areas of Ahmedabad”.
The greatest advantage of survey research study in flexibility and broadness of
scope. It can applied to many populations, it can focus on wide range of topics, and its
information can be used for many purposes.
Comparative survey provided great deal of information in a fairly economical
manner. Comparative descriptive survey method is most appropriate since it makes
study of large sample size possible.
3.2. RESEARCH DESIGN
Burns, Nancy,(2007) research design is investigator’s overall plan for obtaining
answer to the research questions. Research design selected for present study is
comparative survey research design. Investigator was made decision about full nature
of the intervention as part of the research design.
23
Investigator consider design as a precisely conceived blue print that brings to
empirical evidence to bear on the research problem. It provides methodological
direction. Such as a sampling and data analysis. (James,a.f.,2003).
RESEARCH DESIGN
Comparative Survey research design
POPULATION
Adolescent girls of Selected schools of rural and urban areas, Ahmedabad
SAMPLE
200 adolescent girls , 100 from selected schools of urban area and 100 from
selected schools of rural areas in Ahmedabad
of rural and urban areas in Ahmedabad.
SAMPLING TECHNIQUES
Convenient sampling technique
RESEARCH SETTING
Selected Schools of Rural and urban areas of Ahmedabad
TOOLS
STRUCTURED QUESTIONNAIR: IT CONSISTS
Section-I:- Demographic variables
Section-II:- Structured Knowledge Questionnaire
Section-III:- Likert Attitude Scale
DATA ANALYSIS
Data analysis and interpretation by using descriptive and inferential

statistics.
REPORTING FINDINGS
Figure:-3.1-SCHEMATIC REPRESENTATION
24
3.3 RESEARCH SETTING
Research setting is the physical location and condition in which data collection
take place in a study. ( Basvanthappa B. T)
The setting for the study was selected schools of rural and urban area of
Ahmedabad. The Schools of urban areas of Ahmedabad is selected according to areas
of Ahmedabad city and schools of rural areas are selected according to Villages of
Ahmedabad .
Table: 3.1. List of selected areas for research study with sample size.
For Pilot study( Urban)
Areas School name Sample size
Naranpura Sadhana Vinay Mandir 10

School
For Main Study ( Urban )
Vishwabharti School,
Gurukul 50
Gurukul
H B Kapadiya High School,

Delhi Darwaja 50
Delhi Darwaja
Total 100
For Pilot study ( Rural)
Village School name Sample size
Kashindra Kashindra girls school, 10

Kashindra
For Main study ( Rural )
Anasan Vimal Vidhyavihar, Anasan 50
Sarvajanik Vidhyalay,
Barejadi 50
Barejadi
Total 100
Rational: The rationale for selecting these area was for feasibility of
conducting research, easy access to subjects, availability of adequate samples,
administrative approval and expectation of cooperation for conducting study
25
Vimal
Vishwabharti Vidhyavihar,
School, Gurukul Anasan
H B Kapadiya High Sarvajanik

School, Delhi Vidhyalay,
Darwaja Barejadi
Figure:3.2 Map showing the location of selected Schools of Urban and Rural area of Ahmedabad
26
3.4 VARIABLES:
“Variable is a measurable characteristics or attribute of an object or event that may
fluctuate in quantity or quality from one object/event to another.”
DEMOGRAPHIC VARIABLES: Age, Education, Attainment of menarche, Source

of Information, , Attended any programme related to Use of Sanitary Pads?
DEPENDENT VARIABLE: Knowledge and attitude regarding the use of sanitary

pads among adolescent girls studying in selected schools of rural and urban areas of
Ahmedabad.
3.5 TARGET POPULATION
“Population is any group of individuals that have one or more characteristics in
common areas of interest to the researcher.” “The target population refers to the
population that the researcher wishes to study the population about which the
researcher wishes to make generalization”
In this study, target population consist of adolescents girls who are studying in
selected schools of rural and urban area of Ahmedabad.
3.6 SAMPLE SIZE AND SAMPLING TECHNIQUE
Sample population and sampling technique Polit and Beck (2010) said that
“sample is portion of population selected for observation and analysis. Sampling is
process of selecting a portion of the population to represent the entire population.”
For selection of sample, investigator had used a convenient sampling method,
which is also known as judgmental, selective or subjective sampling, is a form of
non- probability sampling in which researcher rely on their own judgment when
choosing members of the population to participate in their study.
Sampling is necessary because it is more economical and efficient to work with
small group of elements. A sample consists of a subset of units that compose the
population. Investigator had adopted probability and non-probability sampling
technique to select the samples. convenient sampling had used for the selection of
selected Schools of rural and urban areas from Ahmedabad.
For the sample selection first investigator selected two Schools from rural
Ahmedabad by convenient sampling. From each School 50 adolescents girls was
selected by convenient sampling method. And two schools selected from Urban
27
areas of Ahmedabad city by convenient sampling From each school 50 adolescents
girls are selected by convenient sampling method.
CRITERIA FOR SAMPLE SELECTION
Inclusion Criteria
1. Adolescents girls from selected schools from selected urban and rural areas of
Ahmedabad.
2. Adolescent girls who can read and communicate in Gujarati.
3. Willing to participate in the study.
Exclusive criteria
1.Who cannot able to communicate in Gujarati.
2.Not willing to participate in the study.
3.7 SELECTION OF TOOL FOR DATA COLLECTION

Basvanthappa, B.T.(2007), stated, “The instrument selected in a research study
should be as far as possible, the vehicle that would best obtain data for drawing
conclusions, pertinent to study and add to the body of Knowledge in a discipline.”
To collect the data for present study following tool was selected and
constructed. Based on the objectives of the study, The investigator developed data
collection tool in order to obtain necessary information. Investigator was Compare
the Knowledge and Attitude regarding use of sanitary pads among adolescent girls
studying in selected schools of rural and urban areas of Ahmedabad. Following
Sections was there in research tool.
Section-A:
It consists of Demographic variables. i.e Age, Education, Attainment of
menarche, Sources of information, and Attended any programme related to Use of
Sanitary Pads?.
Section-B :
Structured Knowledge Questionnaire consisted of items on Knowledge on use of
sanitary pads among adolescent girls studying in selected schools of rural and urban
areas.
Section- C :
The investigator prepared a five-point Likert’s Attitude Scale to assess the
Attitude on use of sanitary pads among adolescent girls studying in selected schools
of rural and urban areas.
28
Rationale:
The Knowledge Questionnaire helps to elicit factual information and it is simple
method for data collection. The close ended questions are efficient, easy to administer
appropriate to get the information on use of sanitary pads. It is also easy to construct
and less time consuming.
3.8 DEVELOPMENT OF DATA COLLECTION TOOL
The development of tool is step by step procedure in order to make tool.
Investigator came across some studies that used Structured Knowledge Questionnaire
and Structured Likert was used to assess the Knowledge and Attitude on use of
areas of Ahmedabad. A review of research and non-research literature, expert’s
opinion and investigator’s experience is the basis for the construction of tool for data
collection for present study. The investigator selected following tools for the data
collection. Investigator developed a Structured Knowledge Questionnaire to assess the
Knowledge and five-point Likert’s Attitude Scale to assess the Attitude on use of
areas of Ahmedabad.
In this section investigator included Structured Knowledge Questionnaire for
Knowledge and five-point Likert’s Attitude Scale for Attitude on use of sanitary
pads. Total 20 questions were there to assess the Knowledge and 10 questions were
there to assess attitude among adolescent girls studying in selected schools of rural
and urban areas of Ahmedabad.
1. Development of Structured Knowledge Questionnaire:
Structured questionnaire focused mainly on the Knowledge on use of sanitary
pads among adolescent girls. Total 20 items had been formulated. It was prepared in
Gujarati as well as in English. The participant were expected to illustrate their
appropriate response according to questions. The time has been allotted for a
Structured Knowledge Questionnaire was 20 minutes.
2.Development of Structured five-point Likert’s Attitude Scale:
Five-point Likert’s Attitude Scale was developed, it was planned to assess
Attitude of samples, expert’s opinion and personal experience of the investigator
were the basis of construction of five-point Likert’s Attitude Scale on use of sanitary
pads. It had helped to rate the individual from total number 10 items.
29
Tool developed according to the objectives of the study
1. Structured Knowledge Questionnaire to assess the Knowledge on use of sanitary
pads among adolescent girls studying in selected schools of rural and urban areas of
Ahmedabad.
2. Five-point Likert’s Attitude Scale to assess the Attitude on use of sanitary pads
among adolescent girls studying in selected schools of rural and urban areas of
Ahmedabad.
The investigator has chosen the following technique in this study:
The comparative descriptive technique has been used to “Assess the Knowledge and
Attitude on use of sanitary pads among adolescent girls studying in selected schools
of rural and urban areas of Ahmedabad.”
3.9 DESCRIPTION OF TOOL
Structured Questionnaire – Investigator developed a Structured Questionnaire
to “Assess the Knowledge and Attitude on use of sanitary pads among adolescent
girls studying in selected schools of rural and urban areas of Ahmedabad
The Structured Questionnaire is an instrument to obtain information of
Knowledge and Attitude use of sanitary pads among adolescent girls studying in
selected schools of rural and urban areas of Ahmedabad.”
It has three sections as follows.
Section A:
It consist of Demographic variables i.e. Age, Education, Attainment of menarche,
Sources of information, and Attended any programme related to Use of Sanitary
Pads?.
Section B:
Structured Knowledge Questionnaire consisted of 20 items on Knowledge on
use of sanitary pads among adolescent girls. Tool items were 20 and each items
carried 1 mark. Maximum score of Questionnaire was 20. Investigator gave “0”
mark for wrong and “1” mark for correct answer. The content area of cognitive
domain was comprised of Knowledge. 20 items were subdivided in sub area of the
content related to use of sanitary pads.
Investigator divided knowledge scores as following and considered samples
knowledge level accordingly.
30
Good knowledge level, knowledge score between 14-20 out of 20. Average
knowledge level, knowledge score between 7-13 out of 20. Poor knowledge level,
knowledge score between 0-6 out of 20.
Investigator prepared the key for structured knowledge questionnaire. Blue print
was prepared according to the content area and the level of Knowledge domain on
questionnaire shown in following table:
Table 3.2:
Blueprint of Structured Knowledge Questionnaire for assessing
Knowledge of the sample on use of sanitary pads.
Sr. Area No. of Items Maximum Percentage
No. Score %
1 Knowledge 1,2,3,11 04 20%
2 Comprehension 4,5,6,12,14,16,17,19 08 40%
3 Application 7,8,9,10,13,15,18,20 08 40%
TOTAL 20 100%
Section C:
Investigator had used five point Likert’s scale. It was consisted ranking
system of Positive Statement on the basis of Strongly Agree-5, Agree-4, Uncertain-3 ,
Disagree-2, Strongly Disagree-1 and the ranking system of Negative Statement on the
basis of Strongly Agree- 1, Agree-2, Uncertain-3,Disagree-4, Strongly Disagree -5.
The tool was consists of 10 question regarding attitude on use of sanitary pads.
The minimum score is 10 and maximum is 50.
1) Unfavourable attitude : 10-30
2) Favourable attitude : 31-50
31
Table: 3.3
Blue print contains the Likert’s Attitude Scale on use of sanitary
pads.
Attitude No. of items Total No. of Percentage
Questions %
Positive Statements 2,3,6,8,10 5 50
Negative Statements 1,4,5,7,9 5 50
TOTAL 10 100
3.10 VALIDITY OF THE TOOL

In order to measure the validity of the tool i.e. Structured Knowledge
Questionnaire and five-point Likert’s Attitude Scale had given to experts. Tools were
validated by 11 experts comprising of 09 Nurse Educators (09 Master of Nursing in
Community health nursing, 02 expert of in the field of preventive and social medicine
and 1 Medical officer and of PHC). They were requested to validate relevancy,
objectivity and appropriateness of the content areas. Tools were developed under
expert guidance to make clarity of each items.
3.11 RELIABILITY OF TOOL

The reliability is a criterion for measuring adequacy, consistency and accuracy
of the tool. The reliability of the tool had been checked before the pilot study. The
reliability of the Structured Knowledge Questionnaire and five-point Likert’s attitude
scale was determined by carrying out an initial try out in selected urban and rural
areas of Ahmedabad district. The reliability of the Structured Knowledge
Questionnaire was determined by split half method, (‘Karl Person’s Formula’).
Reliability of Structured Knowledge Questionnaire was 0.80 which is more than 0.5;
hence the questionnaire was found to be reliable. The reliability of five-point Likert’s
Attitude Scale was determined by split half method, (‘Karl Person’s Formula’).
Reliability of Structured Attitude scale was 0.804 which is more than 0.5; hence the
attitude scale was found to be reliable.
32
3.12 PILOT STUDY
The Pilot study is a small scale try out of final for the major study. The function is to
obtain information for improving the project or assessing its feasibility. (Pilot and
Hunger 1995). The pilot study is a small scale try out of final study. The samples
selected were similar to the final study samples.
The objective of the pilot study is to validate the consistency of the data
collection instrument, adequacy of the contents, feasibility of the study and time
duration required for responding the data collection instrument. Pilot study is a
careful empirical checking of all phases of the study from the collection of the data
of the analysis.
Before the data collect ion for pilot project, prior permission was taken to
conduct pilot study from urban area Sadhana Vinay Mandir school, Ahmedabad
and from rural area Kashindra girls school, Ahmedabad. After obtaining the
permission, the formal letter and pilot study schedule will submitte to the
Principals of school. The objective of the pilot study was to validate the consistency
of the study and time duration required for responding the data collection
instrument. Investigator collected data from the adolescent girls of the schools
regarding use of sanitary pads. Before the data collection investigator introduce
herself to the Principal, explain the purpose of study and also met the samples then
explain the tool to samples and collected information on a structured knowledge
questionnaire and Likert’s attitude scale.
After collection of data investigator analyze the data and made findings.
According to analysis of the data , the majority findings were in The mean knowledge
score of urban Adolescent girls 14.1(70.5%) is grater then the mean knowledge score
of rural Adolescent girls 11.5(57.5%) The mean attitude score of urban Adolescent
girls 42.40(84.8%) is greater then the mean attitude score of rural Adolescent girls
37(74%), There were 70% of Adolescent girls from rural area having average
knowledge and 30% had good knowledge, where as in urban area, 50% Adolescent
girls had poor knowledge and 50% Adolescent girls had average knowledge. And all
girls both rural and urban having positive attitude.
The pilot study revealed that the study is feasible on large population. After
pilot study, it was found that the tool and place was feasible for the study. Therefore,
33
the plan for data collection was finalized, as the investigator did not face any problem
during the pilot study.
3.12. PROCEDURE FOR DATA COLLECTION

Data collection is the gathering of information needed to address of research
problem. Before starting data collection, formal permission has been obtained from
the concerned authorities of selected schools of urban and rural areas of Ahmedabad
The investigator had addressed her to the samples and the objectives of this research
study. Informed consent was obtained by each sample. The Questionnaire were
distributed to all the samples and collected on completion by investigator. The
researcher thanked all the respective authorities and samples for their cooperation.
The main study data collection was done from 08/07/2021 to 13/07/2021 after
obtaining formal permission from Schools of Rural and urban areas. The data were
collected in selected schools of urban and rural areas setting as per the permission.
Also investigator had explained about the purpose of the study, the need for filling
questionnaire accurately and honestly to the samples. The Questionnaire was
distributed among the samples and was collected by the researcher on completion.
Data collection was processed every day. Investigator had found that all the samples
and informant gave good cooperation during data collection process.
3.13 PLAN FOR DATA ANALYSIS
Statistical analysis is the method of rendering quantitative information
meaningfully and intelligently. Moreover, statistical procedure enable the
investigator to reduces, summarize, evaluate, interpret and communicate numerical
information in a meaningful way.
The investigator planned to analyze data by using descriptive and inferential
Statistics. All the data has been analyze by using frequency distribution, percentage
and was presented in the form of the tables and graphs. The Correlation between
Knowledge and Attitude was shown by using Karl Pearson Correlation Coefficient
formula refers to a process for establishing whether there any relationship exist
between two variables or not. Chi Square test has been used to find association
between selected demographic variables and Knowledge as well as Attitude.
SUMMARY
This chapter deals with methodology adopted for the present study. It includes
research approach, research design, variable setting, population, sample, sampling
34
techniques and development of the data collection tool, description of tool, validity,
reliability of tool, pilot study and procedure for data collection and plan for data
analysis.
A comparative survey approach was used in this study to assess the Knowledge
and Attitude on use of sanitary pads among adolescent girls in selected schools of
urban and rural areas of Ahmedabad. The present study was conducted in selected
schools of urban and rural areas. The samples were collected using convenient
sampling method. The samples population consists of 200 Adolescent girls For
collection of data Questionnaire were prepared and validated by experts.
35
CHAPTER- IV
ANALYSIS AND INTERPRETATION
The main purpose of this chapter is to organize and summarize the data for
easy interpretation. This chapter deals with analysis and interpretation of the data
collected during the study from hundred samples. For collecting the data the
Investigator has used structured knowledge questionnaire for the assessment of
knowledge and attitude scale to assess the attitude level regarding use of sanitary pads.
Descriptive and inferential statistics were used for analysis.
The data collected was analyzed on the basis of objectives of the study and
assumptions of the study.
Polit and Hungler (1999) described analysis as “a process of organizing and
synthesizing data such a way that research question can be answered and hypotheses
tested”.
The objectives of the study were:
1. To assess and compare the knowledge regarding Use of sanitary pads among
the adolescent girls studying in selected schools of rural and urban areas of
Ahmedabad.
Ahmedabad.
3. To find out the correlation between the knowledge and attitude regarding Use
of sanitary pads among the adolescent girls studying in selected schools of
rural and urban areas of Ahmedabad.
knowledge regarding Use of sanitary pads among the adolescent girls studying
in selected schools of rural and urban areas of Ahmedabad.
attitude regarding Use of sanitary pads among the adolescent girls studying in
selected schools of rural and urban areas of Ahmedabad.
Assumptions:
1. There will be good knowledge among adolescents girls studying in selected

36
Ahmedabad.
2. There will be positive attitude among adolescents girls studying in selected
Ahmedabad.
3. There will be significant correlation between knowledge score and attitude
score regarding use of sanitary pads among adolescents girls studying in
selected schools of rural and the urban areas of Ahmedabad.
4. There will be significant association between selected demographic variable
and adolescents girl knowledge regarding use of sanitary pads among
Ahmedabad.
5. There will be significant association between selected demographic variable
and adolescents girl attitude regarding use of sanitary pads among adolescents
girls studying in selected schools of rural and the urban areas of Ahmedabad.
ANALYSIS AND INTERPRETATION OF THE DATA
Major findings of the study are presented under following sections and heading: The
obtained data are organized and presented in the following sections:
4.1 Analysis and Interpretation of the demographic Variables of the samples such as
Age, Education, Attainment of menarche, source of information and attended any
programme on Use of sanitary pads.
4.2 Analysis and Interpretation of the data related to assessment and comparison of
knowledge regarding use of sanitary pads among rural and urban adolescent girls
4.3 Analysis and Interpretation of data related to assessment and comparison of
attitude regarding use of sanitary pads among rural and urban adolescent girls
4.4 Analysis and interpretation of data showing correlation between knowledge and
attitude among rural and urban adolescent girls
4.5 Analysis and interpretation of data showing association between knowledge of
rural and urban adolescent girls and selected demographic variables
4.6 Analysis and interpretation of data showing association between attitude of rural
and urban adolescent girls and selected demographic variables
37
4.1 ANALYSIS AND INTERPRETATION OF DEMOGRAPHIC
VARIABLES OF THE SAMPLES
Table 4.1.1.Frequency and Percentage wise distribution of the Demographic

Data. [N=200]
SL Demographic Rural Urban

Variables
No variables f % F %
11-13 years 31 31% 26 26%
Age in 14-16 years 49 49% 54 54%
1
years 17-18 years 20 20% 20 20%
Std 7 -9 49 49% 45 45%
2 Education
Std 10-12 51 51% 55 55%
Yes 75 75% 79 79%

Attained
4 21%
menarche No 25 25% 21
Family 54 54% 28 28%

Source of
5 Friends 24 24% 22 22%
information
Social media 22 22% 50 50%
Yes 17 17% 28 28%

Attended any
6 72%
programme No 83 83% 72
Table 4.1 Shows the demographic characteristic of rural and urban adolescent girls, in
rural area out of 100 samples, in age, 31 (13%) were in 11-13 years, 49 (49%) in 14-
16 years and 20(20%) in 17-18. In education 49(49%) were studying in class 7 – 9 std
and 51(51 %) were in class 10 – 12 std. In data related to attainment of menarche
75(75%) samples were responded yes and 25(25%) samples responded no. In source
of information 54(54%) participants had family as their source of information,
24(24%) were having friends and 22(22%) were having social media as source of
information. In attended program related to use of sanitary pads 17(17%) responded
yes and 83(83%) responded no.
Whereas in urban area out of 100 samples, in age, 26 (26%) were in 11-13 years, 54
38
(54%) in 14-16 years and 20(20%) in 17-18. In education 45(49%) were studying in
class 7 – 9 std and 55(55 %) were in class 10 – 12 std. In data related to attainment of
menarche 79(79%) samples were responded yes and 21(21%) samples responded no.
In source of information 28(28%) participants had family as their source of
information, 22(22%) were having friends and 50(50%) were having social media as
source of information. In attended program related to use of sanitary pads 28(28%)
responded yes and 72(72%) responded no.
39
90 83
79
80 75
72
70
60 54 55 54
49 49 51 50
50 45
40
31
26 28 28
30 25 24 22
20 20 21 22
17
20
10
0
11-13 14-16 17-18 Std 7 -9 Std 10-12 Yes No Family Friends Social Yes No
years years years media
Age in years Education Attained menarche Source of information Attended any
programme
RURAL F URBAN F
Figure-4.1. Bar Graph Showing the distribution of Demographic variables

40
4.2 ASSESSMENT AND COMPARISON OF KNOWLEDGE REGARDING
USE OF SANITARY PADS AMONG RURAL AND URBAN
ADOLESCENT GIRLS
Table-4.2.1 Frequency and percentage wice distribution showing Knowledge
score regarding use of sanitary pads among rural and urban adolescent girls.
[N=200]
Level of Rural Urban
knowledge f % f %
Poor 00 00% 00 00%
Average 71 71% 61 61%
Good 29 21% 39 39%
Total 100 100% 100 100%
Table 4.2.1 Shows that among rural adolescent girls, majority 71 (71%) samples had
average knowledge, 29 (29%) samples had good knowledge and nobody had poor
knowledge regarding use of sanitary pads . Whereas in urban adolescent girls
majority 61(61%) had average knowledge, 39(39%) had good knowledge and nobody
had poor knowledge level regarding use of sanitary pads .
41
Level of knowledge on use of sanitory pads
100
80
71
Percentage
60
61
40 39
Rural
20 29
0
Urban
0
0
Poor
Average
Good
Knowledge Level
Figure-4.2 Bar Graph Showing the Knowledge level of rural and urban adolescent girls regarding use of sanitary pad
42
Table 4.2.2 Mean, Median, Mode, range and Standard Deviation (SD) of the
knowledge scores of rural and urban adolescent girls. [N=200]
Knowledge
Mean Mean% Median Mode SD
assessment
Rural Adolescent
11.48 57.4% 10 10 1.97
girls
Urban Adolescent
13.87 69.35% 14 15 1.18
girls
Table 4.2.2 shows the knowledge scores obtained by rural and urban adolescent girls
on use of sanitary pads . In rural adolescent girls the mean knowledge score was
11.48 and the mean percentage was 57.4%, median score was 10 and the mode was
10 with the standard deviation 1.97. Whereas among the urban adolescent girls the
mean knowledge score was 13.87 and the mean percentage was 69.35%, median
score 14, mode 15 and the standard deviation was 1.18.
Therefore based on the assumptions set in the present study it reveals that the
mean knowledge score of urban adolescent girls 13.87 with mean percentage 69.35%
is greater than mean knowledge score of rural adolescent girls that is 11.48 (57.4%).
43
Table 4.2.3 Comparison of knowledge score of rural and urban adolescent girls
regarding use of sanitary pads. [N=200]
Indepe
Knowledge Mean ndent
Mean Mean % SD Df p value
level difference ‘t’
value
Rural 11.48 57.4% 1.97
2.39 198 10.386 0.001
Urban 13.87 69.35% (11.95%) 1.18
Independent t test was used to compare the knowledge of rural and urban adolescent
girls regarding use of sanitary pads .
Table 4.2.3 Shows the mean knowledge score of urban adolescent girls 13.87 (69.3%)
is greater than the mean knowledge score of rural adolescent girls 11.48(57.4%) with
the mean difference of 2.39(11.95%). The calculated independent t test score 10.386
is greater than the t table value 1.64 at degree of freedom 198 shows the significant
difference between the knowledge score of urban and rural adolescent girls at 0.05
level of significance. Hence we conclude that there is significant difference between
knowledge level of urban and rural adolescent girls. Based on the assumption set in
the present study it shows knowledge of urban adolescent girls is greater than the rural
adolescent girls regarding use of sanitary pads .
44
4.3.ASSESSMENT AND COMPARISON OF ATTITUDE REGARDING USE
OF SANITARY PADS AMONG RURAL AND URBAN ADOLESCENT
GIRLS
Table-4.3.1 Frequency and percentage wice distribution showing attitude score
regarding use of sanitary pads among rural and urban adolescent girls.
[N=200]
Level of Rural Urban
attitude f % f %
Positive 100 100% 100 100%
Negative 00 00% 00 00%
Total 100 100% 100 100%
Table 4.3.1 Shows that all the participants 100(100%) from rural and 100(100%)
from urban area had positive attitude towards use of sanitary pads.
45
Level of attitude on use of sanitory pads
100 100
100
80
Percentage
60
40
Rural
20 Urban
0 0
0
Positive
Negative
Attitude Level
Figure-4.3 Bar Graph Showing the Knowledge level of rural and urban adolescent girls regarding use of sanitary pads.
46
Table 4.3.2 Mean, Median, Mode, range and Standard Deviation (SD) of the
attitude scores of rural and urban adolescent girls. [N=200]
Attitude
Mean Mean% Median Mode SD
assessment
Rural Adolescent
38.97 77.94% 39 39 3.62
girls
Urban Adolescent
42.06 84.12% 42 42 2.90
girls
Table 4.3.2 shows the attitude scores obtained by rural and urban adolescent girls on
use of sanitary pads. In rural adolescent girls the mean attitude score was 38.97 and
the mean percentage was 77.94%, median score was 39 and the mode was 39 with the
standard deviation 3.62. Whereas among the urban adolescent girls the mean attitude
score was 42.06 and the mean percentage was 84.12%, median score 42, mode 42 and
the standard deviation was 2.90.
Therefore based on the assumptions set in the present study it reveals that the
mean attitude score of urban adolescent girls 42.06 with mean percentage 84.12% is
greater than mean attitude score of rural adolescent girls that is 38.97 (77.94%).
47
Table 4.3.3 Comparison of attitude score of rural and urban adolescent girls
regarding use of sanitary pads. [N=200]
Indepe
Attitude Mean ndent
Mean Mean % SD Df p value
level difference ‘t’
value
Rural 38.97 77.94% 3.62
3.09 198 6.912 0.001
Urban 42.06 84.12% (6.18%) 2.90
Independent t test was used to compare the attitude of rural and urban adolescent girls
regarding use of sanitary pads .
Table 4.3.3 Shows the mean attitude score of urban adolescent girls 42.06 (84.12%)
is greater than the mean attitude score of rural adolescent girls 38.97(77.94%) with
the mean difference of 3.09(6.18%). The calculated independent t test score 6..912%
is greater than the t table value 1.64 at degree of freedom 198 shows the significant
difference between the attitude score of urban and rural adolescent girls at 0.05 level
of significance. Hence we conclude that there is significant difference between
attitude level of urban and rural adolescent girls. Based on the assumption set in the
present study it shows attitude of urban adolescent girls is greater than the rural
adolescent girls regarding use of sanitary pads .
48
4.4.CORRELATION BETWEEN KNOWLEDGE AND ATTITUDE AMONG
RURAL AND URBAN ADOLESCENT GIRLS
Karl Pearson’s correlation coefficient method was used to find out the
relationship.
4.4.1. Correlation between knowledge score and attitude score among rural
adolescent girls. [N=100]
Correlation Total
r Level of
between number Df p value Remarks
value significance
knowledge of sample
and attitude Correlation
among is
rural 200 198 0.911 0.001 .05 level significant
adolescent At the 0.05
girls level
Table-4.4.1 The findings shows (0 > r < 1) the very strong positive correlation
between knowledge and attitude of rural adolescent girls. Means as the knowledge
increases the attitude also increases. Statistically The p value 0.001 is lesser than the
0.05 it shows there is significant correlation between knowledge and attitude of rural
adolescent girls regarding use of sanitary pads , r(198) = 0.911, p=0.001.
49
Figure-4.4 Scattered diagram showing the correlation between knowledge and
attitude among rural adolescent girls regarding use of sanitary pads
50
4.4.2. Correlation between knowledge score and attitude score among urban
adolescent girls. [N=100]
Correlation Total
r Level of
between number Df p value Remarks
value significance
knowledge of sample
and attitude Correlation
among is
urban 200 198 0.752 0.001 .05 level significant
adolescent At the 0.05
girls level
Table-4.4.2 The findings shows (0 > r < 1) the moderately positive correlation
between knowledge and attitude of urban adolescent girls. Means as the knowledge
increases the attitude also increases. Statistically The p value 0.001 is lesser than the
0.05 it shows there is significant correlation between knowledge and attitude of rural
adolescent girls regarding use of sanitary pads , r(198) = 0.752, p=0.001.
51
Figure-4.5 Scattered diagram showing the correlation between knowledge and attitude
among rural adolescent girls regarding use of sanitary pads
52
4.5.ASSOCIATION BETWEEN KNOWLEDGE OF RURAL AND URBAN
ADOLESCENT GIRLS AND SELECTED DEMOGRAPHIC VARIABLES
Chi square test was done to find the association between knowledge of rural and
urban adolescent girls and selected demographic variables
4.5.1. Association between knowledge score of rural adolescent girls and selected
demographic variable. [N=100]
Sr. Demographic χ²
Aver Signifi
No Variables f Good χ² Table Df
age cance
value value
Age
a) 11-13 year 31 30 1
1 35.751 5.99 2 S
b) 14-16 Year 49 37 12
c) 17-18 Year 20 04 16
Education
2 a) Std 7 – 9 49 48 1 33.914 3.84 1 S
b) Std 10-12 51 23 28
Attained menarche
3 a) Yes 75 47 28 10.118 3.84 1 S
b) No 25 24 1
Source of information
a) Family 54 42 12
4 b) Friends 24 17 07 4.098 5.99 2 NS
c) Social media 22 10 10
Attended any program

5 a) Yes 17 5 12 17.205 3.84 1 S
b) No 83 66 17
*significance at 0.05 level
Table 4.5.1. Shows that the computed chi square value for the demographic variables
such as age (χ² (2) =35.751; Table value= 5.99), education (χ² (1) =33.914; Table value=
3.84), attainment of menarche(χ² (1) =10.118; Table value= 3.84), source of
information (χ² (2) =4.098; Table value= 3.84),and attended any program (χ² (1)
=17.205; Table value= 3.84),respectively at the level of p< 0.05 level and conclude
that there is association between knowledge score and selected demographic variables
of urban adolescent girls such as age, education, attainment of menarche and attended
any program as the calculated value is more than the table value, where as it was
found non-significant for the demographic variables source of information.
53
4.5.2. Association between knowledge score of urban adolescent girls and
selected demographic variable. [N=100]
Sr. Demographic
No Variables Aver Good χ² Df Signif
f age χ² Table icanc
value value e
Age
a) 11-13 year 26 18 8
1 19.794 5.99 2 S
b) 14-16 Year 54 20 34
c) 17-18 Year 20 1 19
Education
2 a) Std 7 – 9 45 28 17 18.547 3.84 1 S
b) Std 10-12 55 11 44
Attained menarche
3 a) Yes 79 25 54 8.553 3.84 1 S
b) No 21 14 7
a) Family 28 15 13
4 b) Friends 22 8 14 3.593 5.99 2 NS
Attended any program

5 a) Yes 28 5 23 7.307 3.84 1 S
b) No 72 34 38
3.84), attainment of menarche(χ² (1) =8.553; Table value= 3.84), source of information
(χ² (2) =3.594; Table value= 3.84),and attended any program (χ² (1) =7.307; Table
value= 3.84),respectively at the level of p< 0.05 level and conclude that there is
association between knowledge score and selected demographic variables of urban
adolescent girls such as age, education, attainment of menarche and attended any
program as the calculated value is more than the table value, where as it was found
non-significant for the demographic variables source of information.
54
4.6.ASSOCIATION BETWEEN ATTITUDE OF RURAL AND URBAN
ADOLESCENT GIRLS AND SELECTED DEMOGRAPHIC VARIABLES
4.6.1. Association between attitude score of rural adolescent girls and selected
Sr. Demographic
No Variables < >Me χ² Df Signif
f Medi dian χ² Table icanc
an value value e
Age
a) 11-13 year 31 24 7
1 18.475 5.99 2 S
b) 14-16 Year 49 33 16
c) 17-18 Year 20 4 16
Education
2 a) Std 7 – 9 49 40 9 17.193 3.84 1 S
b) Std 10-12 51 21 30
Attained menarche
3 a) Yes 75 42 33 3.153 3.84 1 NS
b) No 25 19 6
a) Family 54 36 18
4 b) Friends 24 15 9 2.986 5.99 2 NS
Attended any
program
5 5 12 8.591 3.84 1 S
a) Yes 17
b) No 83 56 27
association between attitude score and selected demographic variables of urban
adolescent girls such as age, education and attended any program as the calculated
value is more than the table value, where as it was found non-significant for the
demographic variables such as attainment of menarche and source of information.
55
4.6.2. Association between attitude score of urban adolescent girls and selected
Sr. Demographic
No Variables < >Me χ² Signif
f Medi dian χ² Table Df icanc
an value value e
Age
a) 11-13 year 26 19 7
1 15.277 5.99 2 S
b) 14-16 Year 54 26 28
c) 17-18 Year 20
Education
2 a) Std 7 – 9 45 33 12 21.037 3.84 1 S
b) Std 10-12 55 15 40
Attained menarche
3 a) Yes 79 32 47 8.464 3.84 1 S
b) No 21 16 5
a) Family 28 12 16
4 b) Friends 22 11 11 0.412 5.99 2 NS
Attended any
program
5 11 17 1.183 3.84 1 NS
a) Yes 28
b) No 72 37 35
association between attitude score and selected demographic variables of urban
adolescent girls such as age, education and attainment of menarche as the calculated
value is more than the table value, where as it was found non-significant for the
demographic variables like source of information and attended any program.
56
SUMMARY
This chapter deals with the analysis and interpretation of data collected from 200
samples (100 from rural and 100 from urban area), to assess, compare, correlate and
associate the knowledge and attitude regarding use of sanitary pads. Descriptive and
inferential statistics methods were used to analyze the data. The mean knowledge
score of urban adolescent girls 13.87(69.35%) is grater then the mean knowledge
score of rural adolescent girls 11.48(57.4%). The mean attitude score of urban
adolescent girls 42.06(84.12%) is greater than the mean attitude score of rural
adolescent girls 38.97(77.98%). There is significant difference between the
knowledge level of rural and urban adolescent girls ( t=10.386) and there is also
significant difference between attitude level of rural and urban adolescent girls (
t=6.912). There is very strong positive correlation between knowledge and attitude
regarding use of sanitary pads among rural adolescent girls, statistically there was
significant correlation ( p=0.008). There is moderate positive correlation between
knowledge and attitude regarding use of sanitary pads among urban adolescent girls,
statistically there was significant correlation ( p=0.001). There is association between
most of the selected demographic variables and knowledge and attitude score of both
rural and urban adolescent girls.
57
CHAPTER-V
SUMMARY, MAJOR FINDING, DISCUSSION, CONCLUSIONS,
IMPLICATION AND RECOMMENDATION
This chapter present a brief summary of the study along with its findings and
conclusion drawn from the findings. The implication of this study has been stated.
Recommendation for further research on this topic have also been stated.
5.1 SUMMARY
The research approach used for the study was survey method, “A Comparative
study to Assess the Knowledge and Attitude on Use of sanitary pads among Adolescents
girls Studying in selected Schools of Rural and Urban Areas of Ahmedabad.
OBJECTIVES
1. To assess and compare the knowledge regarding Use of sanitary pads among the
Ahmadabad.
Ahmadabad.
3. To find out the correlation between the knowledge and attitude regarding Use of
knowledge regarding Use of sanitary pads among the adolescent girls studying in
selected schools of rural and urban areas of Ahmadabad.
5. To find out the association between selected demographic variables and attitude
regarding Use of sanitary pads among the adolescent girls studying in selected
schools of rural and urban areas of Ahmadabad.
Survey approach was considered the most suitable, as the purpose of descriptive
survey is to gather data. Present study was undertaken among 200 adolescents girls from
selected schools of rural and urban areas of Ahmedabad. A structured Knowledge
Questionnaire comprising 20 items related to Knowledge on use of sanitary pads and
58
five-point Likert’s Attitude Scale comprising 10 items related to Attitude was assessed
after review of literature and under the guidance of guide to co-guide, validity and
reliability of tools were established before conducting the pilot study.
Total 200 samples were taken from selected schools of rural and urban areas, which
were selected by Convenient sampling Method . The investigator collected the data by
establishment of rapport with subject and confidentiality of their responded was
assured. The pilot study was conducted in Urban area School on date of 14th Jun,2021
and rural area school on date of 1 2 t h J u n , 2 0 2 1 . Final data was collected 8th July
2021, to 13th July, 2021. The data were analyzed and interpretation in term of objectives
of the study. Comparative descriptive survey and inferential statistics were utilized for
data analysis.
5.2.MAJOR FINDING OF THE STUDY
The data were analyzed and interpreted in terms of objective of the study. Descriptive
and inferential statistics were utilized for the data analysis. After analysis the data major
findings of the study were as follow:
1. Findings related to demographic data of Samples regarding use of sanitary pads.
2. Findings related to knowledge of Samples regarding use of sanitary pads.
3. Findings related to Attitude of Samples regarding use of sanitary pads.
4. Findings related to Correlation between knowledge and attitude among rural and urban
adolescent girls.
5. Findings related to association between knowledge of rural and urban adolescent girls
and selected demographic variables.
6. Findings related to association between attitude of rural and urban adolescent girls and
selected demographic variables.
1. Findings related to demographic data of Samples regarding use of sanitary pads:-
Demographic characteristic of rural and urban adolescent girls, in rural area out of 100
samples, in age, 31 (13%) were in 11-13 years, 49 (49%) in 14-16 years and 20(20%) in
17-18. In education 49(49%) were studying in class 7 – 9 std and 51(51 %) were in class
10 – 12 std. In residence 100 (100%) were from rural area.In data related to attainment of
menarche 75(75%) samples were responded yes and 25(25%) samples responded no. In
source of information 54(54%) participants had family as their source of information,
59
24(24%) were having friends and 22(22%) were having social media as source of
information. In attended program related to use of sanitary pads 17(17%) responded yes
and 83(83%) responded no.
Whereas in urban area out of 100 samples, in age, 26 (26%) were in 11-13 years, 54
(54%) in 14-16 years and 20(20%) in 17-18. In education 45(49%) were studying in class
7 – 9 std and 55(55 %) were in class 10 – 12 std. In residence 100 (100%) were from
urban area.In data related to attainment of menarche 79(79%) samples were responded yes
and 21(21%) samples responded no. In source of information 28(28%) participants had
family as their source of information, 22(22%) were having friends and 50(50%) were
having social media as source of information. In attended program related to use of
sanitary pads 28(28%) responded yes and 72(72%) responded no.
2. Findings related to knowledge of Samples regarding use of sanitary pads:-
Mean knowledge score of urban adolescent girls 13.87 (69.3%) is greater than the mean
knowledge score of rural adolescent girls 11.48(57.4%) with the mean difference of
2.39(11.95%). The calculated independent t test score 10.386 is greater than the t table
value 1.64 at degree of freedom 198 shows the significant difference between the
knowledge score of urban and rural adolescent girls at 0.05 level of significance. Hence
we conclude that there is significant difference between knowledge level of urban and
rural adolescent girls. Based on the assumption set in the present study it shows
knowledge of urban adolescent girls is greater than the rural adolescent girls regarding
use of sanitary pads .
3. Findings related to Attitude of Samples regarding use of sanitary pads:-
Mean attitude score of urban adolescent girls 42.06 (84.12%) is greater than the mean
attitude score of rural adolescent girls 38.97(77.94%) with the mean difference of
3.09(6.18%). The calculated independent t test score 6..912% is greater than the t table
value 1.64 at degree of freedom 198 shows the significant difference between the attitude
score of urban and rural adolescent girls at 0.05 level of significance. Hence we conclude
that there is significant difference between attitude level of urban and rural adolescent
girls. Based on the assumption set in the present study it shows attitude of urban
adolescent girls is greater than the rural adolescent girls regarding use of sanitary pads .
60
4. Findings related to Correlation between knowledge and attitude among rural and
urban adolescent girls:-
 Among rural adolescents girls the findings shows (0 > r < 1) the very strong
positive correlation between knowledge and attitude of rural adolescent girls.
Means as the knowledge increases the attitude also increases. Statistically The p
value 0.001 is lesser than the 0.05 it shows there is significant correlation between
knowledge and attitude of rural adolescent girls regarding use of sanitary pads ,
r(198) = 0.911, p=0.001.
 Among urban adolescents girls the findings shows (0 > r < 1) the moderately
positive correlation between knowledge and attitude of urban adolescent girls.
Means as the knowledge increases the attitude also increases. Statistically The p
value 0.001 is lesser than the 0.05 it shows there is significant correlation
between knowledge and attitude of rural adolescent girls regarding use of
sanitary pads , r(198) = 0.752, p=0.001.
5. Findings related to association between knowledge of rural and urban adolescent
girls and selected demographic variables:-
 Among rural adolescents girls computed chi square value for the demographic
variables such as age (χ² (2) =35.751; Table value= 5.99), education (χ² (1) =33.914;
Table value= 3.84), attainment of menarche(χ² (1) =10.118; Table value= 3.84),
source of information (χ² (2) =4.098; Table value= 3.84),and attended any program
(χ² (1) =17.205; Table value= 3.84),respectively at the level of p< 0.05 level and
conclude that there is association between knowledge score and selected
demographic variables of urban adolescent girls such as age, education,
attainment of menarche and attended any program as the calculated value is more
than the table value, where as it was found non-significant for the demographic
variables source of information.
 Among urban adolescents girls computed chi square value for the demographic
61
conclude that there is association between knowledge score and selected
demographic variables of urban adolescent girls such as age, education,
attainment of menarche and attended any program as the calculated value is more
than the table value, where as it was found non-significant for the demographic
variables source of information.
6. Findings related to association between attitude of rural and urban adolescent
girls and selected demographic variables:-
 Among rural adolescents girls computed chi square value for the demographic
conclude that there is association between attitude score and selected
demographic variables of urban adolescent girls such as age, education and
attended any program as the calculated value is more than the table value, where
as it was found non-significant for the demographic variables such as attainment
of menarche and source of information.
 Among urban adolescents girls computed chi square value for the demographic
conclude that there is association between attitude score and selected
demographic variables of urban adolescent girls such as age, education and
attainment of menarche as the calculated value is more than the table value, where
as it was found non-significant for the demographic variables like source of
information and attended any program.
5.3 DISCUSSION
The present study addressed to “A Comparative study to Assess the Knowledge and
attitude on use of sanitary pads among Adolescents girls studying in Selected schools of
62
Rural and urban Areas of Ahmedabad.” Comparative descriptive survey design was
adopted for the present study. Convenient sampling was used to select the samples. The
data was collected from 200 samples using Structured Knowledge Questionnaire to assess
the Knowledge and five-point Likert’s Attitude Scale to assess the Attitude.
In similar study conducted by Priyanka Kumar*, S.B. Gupta, Imtiaz
Danish(2018) A Study Conducted for compare the practices of urban and rural school
going adolescent girls regarding menstrual hygiene. It was a descriptive cross sectional
study carried out in Government and private schools located in the areas served by UHTC
and RHTC of Department of Community Medicine, SRMS IMS, Bareilly (UP).
Adolescent girls studying in 6 th to 10th class in selected schools comprised the study
population. Inclusion criteria were adolescent girls aged 10–19 years who had attained
menarche and were studying in 6th to 10th class in the selected schools. Three fourth 142
(75.5%) of rural girls were following restrictions during menses as compared to less
number of urban subjects 126 (71.6%). The most common restriction followed was not
attending religious function as practiced by 73.9% and 66.7% of rural and urban girls
respectively. Study on the use of material during menses revealed that the use of sanitary
pads was more common among urban adolescent girls (62.5%) compared to rural
(35.1%). Most common reason cited for not using sanitary pad was high cost as reported
by 42.6% and 43.9% of rural and urban girls respectively. Overall menstrual practices
were better in urban as compared to rural girls.
Shekhar Chauhan, Pradeep kumar (2020) A study conducted over Examining the
predictors of use of sanitary napkins among adolescent girls:A multi-level approach The
study uses information from the Understanding the Lives of Adolescents and Young
Adults (UDAYA) project survey conducted in Uttar Pradesh and Bihar in 2016. The
study sample consisted of 14,625 adolescent girls aged 10–19 years. The study sample
was selected using a multi-stage systematic sampling design. Multilevel logistic
regression (MLR) was used to identify the individual and community level factors
associated with the use of sanitary napkins. The results revealed a wide variation in
sanitary napkins’ use across the socio-economic and demographic factors. The use of
sanitary napkins was significantly higher among girls with 8–9 (53.2%) and 10 and more
(75.4%) years of schooling compared to those who had no formal education (26.4%). The
63
use of sanitary napkins was higher among adolescent girls who were not engaged in paid
work (54.7%) than those who did any paid job (40.8%). Adolescent girls reporting
frequent exposure to mass media (OR = 2.10), belonging to the richest wealth quintile
(OR = 3.76), and whose mothers had 10 or more years of education (OR = 2.29) had a
higher propensity to use sanitary napkins than their counterparts. We did not find a
significant role of community-level education of mothers on the menstrual hygiene
practices of adolescents.
5.4. CONCLUSION
From the above findings it was considered that the adolescents girls had average
knowledge on use of sanitary pads and positive attitude on use of sanitary pads. The
knowledge and attitude are significantly correlated. This implies that as the knowledge of
samples on use of sanitary pads increases, their attitude level also become more positive.
The study conducted that large number of samples having average knowledge on
selected use of sanitary pads specially in female reproductive system, menstrual cycle,
and use of sanitary pads. The study findings revealed that among the urban adolescents
girls have more knowledge then rural adolescents girls. As the adolescents having
average knowledge, so there is greater need for awareness to make the adolescents girls
free from misconception related to use of sanitary pads.
5.5 IMPLICATION AND UTILIZATIONS
Heath care must prevent before promote and curative. The finding of the study
have several implication in the nursing practice, nursing education and nursing research
and nursing administration.
NURSING PRACTICE
The extended and expended role of the professional nurses emphasizes those
activity which promote the health and prevent illness. Role of nurse are multifaceted and
numerous. Nurses are innovators, guides and also teaches. They are a vital link in the
health care delivery system. Nurses play the roles of teacher and a guide in community
setting. Hence nurse could play a circular role in increasing knowledge regarding use of
sanitary pads and simultaneously develop desirable attitude among adolescents girls. The
study finding can be used to bring out awareness among adolescents girls regarding use
of sanitary pads to make the adolescents girls free from misconception.
64
NURSING EDUCATION
Youth are the future of the nation. They are healthy, active, dynamic and receptive
and constitute a greater proportion of population. Moreover youngsters have a better
understanding on healthcare requirements of our country should come in forefront. The
rapid globalization and influence of mass media and internet lead to change in the habit
and knowledge of people by creating awareness regarding prevention rather than cure.
This trend has lead to evolution of health care from a curative aspect to a broader
promotive and preventive aspect. Nurses can work with the educational institutions to
create awareness about use of sanitary pads. The result of the study can be used by
nursing teacher as an informative illustration for adolescents girls.
NURSING RESEARCH
The result of the study contributes to the body of the knowledge of nursing. In
future, the investigators can be use the findings and the methodology as reference
material. It highlights the area which requires future exploration. Other researcher
conducting further studies in same field, can utilize the suggestions and
recommendations.
Further studies can be conducted on this topic for broader and in-depth coverage
of the sample population so as to get a more details information regarding the knowledge
and attitude on use of sanitary pads among adolescents girls. A teaching material, which
will be effective in improving the knowledge and attitude on use of sanitary pads, can
also be implemented.
NURSING ADMINISTATION
Necessary administrative support is provided for the development of such
educational materials like guideline, information booklet, pamphlet etc. nursing personnel
should be motivated and provision for nurses to devote their time for development of
educational materials.
The findings of the study revealed that need to develop a guideline to impart
knowledge and create awareness about use of sanitary pads among adolescents girls.
Nurses can work in sync with management to create awareness about use of sanitary
pads.
65
5.6 RECOMANDATION FOR FUTURE STUDY
1. A similar study can be under taken on large scale which may help to drew more
definite concussion and generalization
2. A exploratory study can be conducted to identify the awareness, knowledge and
attitude of use of sanitary pads.
3. A study can be conducted by using other plan teaching programme.
4. A Study to assess the awareness and knowledge regarding use of sanitary pads among
the adolescents girls in rural areas.
5. The study may be replicated by quasi experimental approach.
66
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Ross & Wilson. (2011). Anatomy and Physiology. 10th edition.. Churchill
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S. K. Sharma, “Nursing Research and Statistics”, Elsevier India Pvt. Ltd, New
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67
Terri Kyle.(2008). Essentials of Pediatric Nursing. South Asian edition.,
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Comparative Study on Menstrual Hygiene Among Urban and Rural
Adolescent Girls of West bangal, J Family med prime care (2014) Oct-Dec;
3(4): 413–417.
Chauhan S, Kumar P, Marbaniang SP, Srivastava S, Patel R, Dhillon P

(2020) Examining the predictors of use of sanitary napkins among adolescent
girls: A multi-level approach. PLoS ONE 16(4): e0250788.
https://doi.org/10.1371/journal.pone.0250788
Dongre, A.R., Deshmukh, P.R., &Garg, B.S. (2014). The effect of

community-based health education intervention on management of menstrual
hygiene among rural Indian adolescent girls. World Health Population, 9(3),
48-54.
Dasgupta, A., &Sarkar, M. (2010). Menstrual hygiene: How hygienic is

adolescent girl? Indian Journal of Community Medicine,33(2), 77-80.
Nair, M.K., Chacko, D.S., Ranjith Darwin, M., Padan, K., & George,
B.P.S.R. (2012). Menstrual disorders and menstrual hygiene practices in
higher secondary school girls. Indian Journal of Pediatrics, 1(Supp.), 74-78.
Mandal, K. (2012). “Teaching adolescent school girls about menstrual

hygiene and midwifery”. Indian Journal of Nursing and Midwifery, 1(a), 19-
26.
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Praveen gautam, Nirmal Kiron (2018) Study of menstrual hygienic practices
and reproductive tract infection among the adolescents girls, National Journal
of Medical and Dental Research, July-September 2018: Volume-6, Issue-4,
Page 500-503.
Pradeep Senapathi, Hemant Kumar (2017). A comparative study of

menstrual hygiene management among rural and urban adolescent girls in
Mangaluru, Karnataka. International Journal of Community Medicine and
Public Health , Senapathi P et al. Int J Community Med Public Health. 2018
Jun;5(6):2548-2556
Priyanka Kumar*, S.B. Gupta, Imtiaz Danish (2018). A Comparative

Study of Menstrual Practices among Urban and Rural Adolescent School Girls
in Bareilly District, India, Int.J.Curr.Microbiol.App.Sci (2016) 5(3): 42-46.
Rajanbir Kaur, Kanwaljit Kaur.(2018), Menstrual Hygiene, Management,

and Waste Disposal: Practices and Challenges Faced by Girls/Women of
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Rao, S., Joshi, S., &Kanade, A. (2010). Height velocity, body fat and
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syndromic approach in management of reproductive tract infections in women.
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69
WEBSITES
http://www.ddmed.org/pdfs
http://en.wikipedia.org/wiki
http://www.nimh.nih.gov
https://www.ncbi.nlm.nih.gov/pubmed
https://www.ncbi.nlm.nih.gov/pmc
https://www.researchgate.net.
70
APPENDIX-A
RESEARCH TOOL
INFORM CONSENT
Code no.:-___________
I, the underdesigned person, am ready to take part in the following research study and
willing to co-operate with the investigator Ms. Suhani Joshi by providing necessary
information. I had been informed that the information provided would be kept
confidential and used only for the below mentioned study purpose.
TOPIC:-
“A COMPARATIVE STUDY TO ASSESS THE KNOWLEDGE AND

ATTITUDE REGARDING THE USE OF SANITARY PADS
AMONG ADOLESCENT GIRLS STUDING IN
SELECTED SCHOOLS OFRURAL
AND URBAN AREAS OF
AHMEDABAD.”
DATE-
PLACE- SIGN OF PARTICIPANT
71
SECTION-A
DEMOGRAPHIC DATA
Instruction:
 Please read carefully and write answer in box. (a,b,c,d)

1. Age [ ]
a) 11-13 Years
b) 14-16 Years
c) 17-18 Years
2. Education [ ]
a) Std-7-9
b) Std-10-12
3. Did you attain Menarche? [ ]
a) Yes
b) No
4. Source of information [ ]
a) Family
b) Friends
c) Social Media
5. Have you attended any programme related to Use of Sanitary Pads?
[ ]
a) Yes
b) No
72
SECTION-B
STRUCTURED KNOWLEDGE QUESTIONNAIRE
Instruction: Please read the question carefully and Write the correct answer(a,b,c,d)
in column.
1. Which is the female reproductive organ? [ ]
a) Kidney
b) Uterus
c) Urethra
d) Intestine
2. Which part of reproductive system produces ovum ? [ ]
a) Uterus
b) Fallopian tube
c) Ovaries
d) Vagina
3. What is the meaning of Menstruation? [ ]
a) Bleeding from Vagina
b) Bleeding from Nose
c) Bleeding from ears
d) Bleeding from Mouth
4. What is the normal age of Menarche? [ ]
a) 5-7 year
b) 8-10year
c) 12-14year
d) Above 14 year
5. What is the normal interval between two menstruation cycle? [ ]
a) 18-22 days
b) 23-27 days
c) 28-32 days
d) 33-35 days
73
6. What is the normal duration of Menstruatrual flow? [ ]
a) 1 day
b) 3-5 days
c) 6-8 days
d) 9-11 days
7. Which type of diet is appropriate to consume during menstrual periods?
[ ]
a) Spicy diet
b) Soft diet
c) High calorie diet
d) Fat diet
8. What does stress cause in adolescent girls? [ ]
a) Remains Normal and Healthy
b) Cessation of Periods
c) Irregular periods
d) B and C correct
9. Which of the following disease occurs due to Unhygienic menstrual practice?
[ ]
a) Reproductive tract Infection
b) Hernia
c) Cancer
d) Appendicitis
10. Why the sanitary pads need to be changed frequently? [ ]
a) To Prevent Anemia
b) To Prevent Diarrhoea
c) To Prevent Wound
d) To prevent Rashes and infection
11. What are the sign of infection due to use of sanitary pads? [ ]
a) Itching and rashes
b) Swelling over perineal area
c) Abnormal vaginal discharge
d) All of above
74
12. Which is the best method used to absorb the menstrual blood flow?
[ ]
a) Ashes
b) Napkins
c) Sanitary pads
d) Panties
13. How many times the girls need to change their sanitary pad during
Menstruation? [ ]
a) Once in day
b) Every 4-6 hr
c) Every 8-10 hr
d) Every 12 hr
14. Which of the following method is used to disposed sanitary pads? [ ]
a) Burn
b) Flush in Toilet
c) Bury in a pit
d) After wash Throw in Dustbin
15. Which of the following statement is incorrect about sanitary pads?
[ ]
a) Sanitary pads is having poor absorbency
b) When it is used for prolonged time cause irritation
c) It is air permeable
d) None of above
16. Which of the following technique is used for washing the perineal area during
Menstruation? [ ]
a) Vagina to Anus
b) Anus to Vagina
c) Only Perineal Area
d) All of Above
17. What are the benefits of using Sanitary pads? [ ]
a) Prevent Infection
b) Maintain hygiene
c) Prevent leakage
d) All of above
75
18. What girl can do if girl get fungal infection over the perineal area due to
sanitary pad? [ ]
a) Change the sanitary pad
b) Apply talcum powder
c) Refer the doctor
d) Clean the perineal area with soap water
19. Which is the proper time duration for maintaining menstrual hygiene during a
day? [ ]
a) After attending toilet
b) Once in a day
c) Twice a day
d) During Bath time
20. Which cleaning product are use to prevent or treat infection or itching?
[ ]
a) Oil
b) Perfumes
c) Powder
d) None of above
76
SECTION-C
LIKERT’S ATTITUDE SCALE
INSTRUCTION:
 Please read the following statements carefully and give the answer by put the
tick( √ ) mark in appropriate column whether you Strongly Agree (SA),
Agree (A), Uncertain (UC), Disagree (DA) or Strongly Disagree (SD).
SR
STATEMENTS SA A UC DA SD
NO.
Menstruating girl should be

1
isolated
Cleaning of vigina should be

2 done at 2 to 3 times daily during
menstruation
Information on use of sanitary

3 pads is important for adolescent
girls
It is too shameful to discuss

4
menstruation
Menstruation occurs because of

5
disease.
During menstruation girls must

6
use sanitary pads
Every girl will experience

7 redness and rashes after use of
sanitary pads
Sanitary pads should be changed

8
frequently
Discontinue the use of sanitary

9
pads due to discomfort
Sanitary pad should be more
10
preferred than napkin.
77
સમંતિ પત્રક
કોડ નં:_________________
હ ું નીચે સહી કરનાર, અત્રે દર્ાાવેલ સુંર્ોધન અભ્યાસ માું સ્વેચ્છઓ ભાગ લઉં છું. હ ું આ
સવેક્ષણ કરનાર ક. સહાની જોષી ને જરૂરી માહહતી પરી પાડી સહકાર આપવા સહમતત
દર્ાાવ ું છું. મને જણવવામાું આવેલ છે કે, હ ું જે માહહતી આપીર્ તે ગપ્ત રાખવામાું
આવર્ે અને નીચે મજબ ના સવેક્ષણમાું જ તેનો ઉપયોગ કરવામાું આવર્ે.
સર્વે ક્ષણ નો તર્વષય:
“ગજરાત રાજ્ય ના અમદાવાદ જીલ્લા ના ર્હેરી અને ગ્રામીણ તવસ્તારની ર્ાળામાું
ભણતી હકર્ોરવયની છોકરીઓ માું સેતનટરી પેડ ના ઉપયોગ અંગે ના
જ્ઞાન અને વલણન ું ન ું મ ૂલ્યાુંકન કરવા માટે એક
તલનાત્મક અભ્યાસ”
સ્થળ: સહભાગી ના હસ્િાક્ષર:
78
તર્વભાગ ૧
વ્યક્તિગિ માહહિી
સ ૂચના - કૃપા કરીને નીચેની બાબતો અને તેના વૈકલ્લ્પક પ્રતતસાદ ને કાળજીપ ૂવાક
વાુંચો.સૌથી યોગ્ય પ્રતતસાદ પસુંદ કરો અને તેને (A,B,C,D) લખો .જો જરૂરી હોય તો
માહહતી લખો.
િારીખ -------------- કોડ નંબર------
૧. વય જૂ થ___________ ( )
a) ૧૧-13 વષા
b) ૧૪-૧૬ વષા
c) ૧૭-૧૮ વષા
૨.અભ્યાસ__________ ( )
a) ધોરણ-૭-૯
b) ધોરણ-૧૦-૧૨
૪.શ ું તમને પ્રથમ માતસકસ્ત્રાવ આવી ગયેલ છે ? ( )
a) હા
b) ના
૫. માહહતી સ્ત્રોત ( )
a) પહરવાર
b) તમત્રો
c) સોતસયલ મીહડયા
d) અન્ય કોઈ
૬. શ ું તમે સેતનટરી પેડ નો ઉપયોગ કે વી રીતે કરવો તેવા કોઈ પ્રોગ્રામ માું ભાગ
લીધેલો છે ? ( )
a) હા
b) ના
79
તર્વભાગ-૨
સે તનટરી પેડ નો ઉપયોગના જ્ઞાન ન ં મ ૂલયાંકન કરર્વા માટે એક માળખાગિ પ્રશ્નાર્વલી.
સ ૂચના -કૃપા કરીને નીચેની બાબતો અને તેના વૈકલ્લ્પક પ્રતતસાદ ને કાળજીપ ૂવાક
વાુંચો.સૌથી યોગ્ય પ્રતતસાદ પસુંદ કરો અને તેની સામે ના ખાના માું (a,b,c,d) લખો.
૧. આમાુંથી કય ું અંગ સ્ત્રીના પ્રજનનતુંત્ર ન ું છે ? ( )
a) હકડની
b) ગભાાર્ય
c) મ ૂત્રમાગા
d) આંતરડા
૨. સ્ત્રીના પ્રજનનતુંત્ર ના કયા ભાગ માથી અંડકોષ ઉત્પન થાય છે ? ( )
a) ગભાાર્ય
b) ગભાાર્ય ની નળી
c) અંડાર્ય
d) યોની
૩. માતસક સ્ત્રાવ શ ું છે ? ( )
a) યોતન માથી લોહી નીકડવ ું
b) નાક માથી લોહી નીકડવ ું
c) કાન માથી લોહી નીકડવ ું
d) મોઠામાથી લોહી નીકડવ ું
૪. પ્રથમ માતસક સ્ત્રાવ કઈ વયે આવે છે ? ( )
a) ૫-૭ વષા
b) ૮-૧૦ વષા
c) ૧૨-૧૪ વષા
d) ૧૪ વષા થી ઉપર
80
૫. સામાન્ય રીતે બે માતસક ચક્ર વચ્ચે કે ટલા હદવસ નો અંતરાલ હોય છે ? ( )
a) ૧૮-૨૨ હદવસ
b) ૨૩-૨૭ હદવસ
c) ૨૮-૩૨ હદવસ
d) ૩૩-૩૫ હદવસ
૬. સામાન્ય રીતે માતસક સ્ત્રાવ કેટલા હદવસ સધી આવે છે ? ( )
a) ૧ હદવસ
b) ૩-૫ હદવસ
c) ૬-૮ હદવસ
d) ૯-૧૧ હદવસ
૭. માતસક સ્ત્રાવ વખતે કયા પ્રકાર નો ખોરાક લેવો જોઈએ? ( )
a) તીખો ખોરાક
b) લોહ તત્વ યક્ત નરમ ખોરાક
c) વધારે કે લોરી વાડો ખોરાક
d) ચરબી વાડો ખોરાક
૮. હકર્ોર વય ની છોકરીઓ માું તણાવની શ ું અસર થાય છે ? ( )
a) કોઈ અસર થતી નથી

b) માતસક સ્ત્રાવમાું અટકાવ આવે
c) અતનયતમત મતસક સ્ત્રાવ આવે
d) b અને c યોગ્ય છે
૯. નીચેના માથી કયો રોગ અસ્વસ્થ માતસક હક્રયાઓ કરવાથી થાય છે ? ( )
a) પ્રજનન માગા માું ચેપ

b) સારું ગઠ
c) કે ન્સર
d) આંત્ર પ ૂછ માું ચેપ
૧૦. કે મ સેતનટરી પેડ ને અમક અંતરાલ એ બદલવા જોઈએ? ( )
a) પાુંડ રોગ ના થાય

b) ઝાડા ના થાય
81
c) ઘા ના થાય
d) ચકમા અને ચેપ ના લાગે
૧૧. સેતનટરી પેડ ના ઉપયોગ થી થતાું ચેપ ના ચચન્હો કયા છે ? ( )
a) ખુંજવાડ અને ચકમા

b) યોતન તવસ્તાર ની ઉપર સોજો આવી જવો
c) અસામાન્ય યોતનમા થી સ્ત્રાવ થવો
d) ઉપરોક્ત બધા યોગ્ય છે
૧૨. કઇ વસ્ત માતસક સ્ત્રાવ માું આવતા લોહીને સોકવા માટે સારી રીતે ઉપયોગી છે ?
( )
a) રાખ
b) નેપહકન
c) સેતનટરી પેડ
d) પેન્ટીસ
13. માતસક સ્ત્રાવ દરતમયાન છોકરીઓ એ હદવસમાું કે ટલી વાર સેતનટરી પેડ બદલવા
જોઈએ? ( )
a) હદવસ માું એક જ વાર

b) દર ૪ થી ૬ કલાકે
c) દર ૮ થી ૧૦ કલાકે
d) દર ૧૨ કલાકે
૧૪. નીચેના માથી કઈ રીત નો ઉપયોગ કરી સેતનટરી પેડનો તનકાલ કરવામાું કરવામાું
આવે છે ? ( )
a) બાળી નાખવ ું
b) ટોઇલેટ માું નાખવ ું
c) એક ખાડા માું દફનાવી
d) ધોયા પછી કચરા પેટી માું નાખવ ું
૧૫. નીચેના માથી કય ું વાક્ય સેતનટરી પેડ તવષે ખોટું છે ? ( )
a) સેતનટરી પેડ માું સોકવાની ક્ષમતાઓછી હોય છે

b) જો સેતનટરી પેડ નો ઉપયોગ લાુંબા સમય સધી કરવામાું આવે તો બળતરા
થાય.
c) તેમાથી હવા પસાર થઈ ર્કે છે
82
d) ઉપરના વાક્યો માથી એક પણ નહહ
૧૬. માતસક સ્ત્રાવ દરતમયાન નીચેના માથી કઈ તકનીક ધ્વારા યોતન ની આજબાજના
તવસ્તાર ને સાફ કરવામાું આવે છે ? ( )
a) યોતન થી ગદા તરફ

b) ગદા થી યોતન તરફ
c) ખાલી યોતન તવસ્તાર
d) ઉપરોક્ત તમામ
૧૭. સેતનટરી પેડ ને ઉપયોગ કરવાના ફાયદા શ ું છે ? ( )
a) ચેપ ના લાગે
b) સ્વસ્થતા જળવાઈ રહે
c) લીકે જ ના થાય
d) ઉપરોક્ત તમામ
૧૮. જો કોઈ છોકરી ને સેતનટરી પેડ ના લીધે યોતન તવસ્તાર માું ફૂગ નો ચેપ લાગે તો
શ ું કરવ ું જોઈએ? ( )
a) સેતનટરી પેડ બદલવ ું

b) ટે લકમ પાઉડર લગાવો
c) ડોક્ટર ને બતાવવ ું
d) સાબ અને પાણીથી યોતન તવસ્તાર સાફ કરવો
૧૯. માતસક સ્ત્રાવ વખતે માતસક સ્વચ્છતા જાળવા માટે નો કયો સમય અંતરાલ યોગ્ય
છે ? ( )
a) ટોઇલેટ ગયા પછી

b) હદવસ માું એક વાર
c) હદવસ માું બે વાર
d) સ્નાન કરતી વખતે
૨૦. નીચેના માથી કઈ વસ્ત નો ઉપયોગ ચેપ અને ખુંજવાળ થી બચવા થાય છે ?
( )
a) તેલ
b) સ્પ્રે
c) પાઉડર
d) ઉપરોક્ત એક પણ નઇ
83
તર્વભાગ-૩
સે તનટરી પેડ ના ઉપયોગ તર્વશે ન ં મ ૂલયાંકન કરર્વા માટે લલકટટ ન ં ર્વલણના ધોરણ
સ ૂચના : તનવેદનને કાળજીપ ૂવાક વાુંચો અને આપેલ જવાબ (તમે સુંપ ૂણા સહમત,
સહમત, અતનતિત, અસહમત, અને સુંપ ૂણા અસહમત) ના યોગ્ય કોલમમાું ટીક માકા (√)
કરો. એસએ = સુંપ ૂણા સહમત, એ = સહમત, ય = અતનતિત, ડી = અસહમત, એસડી =
સુંપ ૂણા અસહમત
અન. સંપ ૂણટ સંપ ૂણટ

તનર્વેદન/ ર્વાક્યો સહમિ અતનતિિ અસહમિ
નં. સહમિ અસહમિ
૧ માતસક સ્ત્રાવ દરતમયાન
છોકરીઓ ને અલગ રાખવી
જોઈએ
૨ માતસક સ્ત્રાવ દરતમયાન યોતન
ને દરરોજ ૨ થી ૩ વાર સાફ
કરવી જોઈએ
૩ સેતનટરી પેડ ના ઉપયોગ
તવર્ેની માહહતી હકર્ોર વય
ની છોકરીઓ માટે ઉપયોગી
છે .
૪ માતસક સ્ત્રાવ તવર્ે વાત
કરવી ર્રમ જનક છે ॰
૫ માતસક સ્ત્રાવ કોઈ રોગ ના
લીધે આવે છે .
૬ માતસક સ્ત્રાવ દરતમયાન
છોકરીઓ એ સેતનટરી પેડ
નો ઉપયોગ કરવો જ
84
જોઈએ.
૭ દરે ક છોકરીઓ ને સેતનટરી
પેડ ના ઉપયોગ પછી ચકમાું
અને લાલાર્ જેવ થાય છે .
૮ સેતનટરી પેડ ને અમક
અંતરાલ એ બદલતા રહેવ ું
જોઈએ
૯ અવગડતા ના કારણે
સેતનટરી પેડ ને ઉપયોગ માું
લેવાન ું બુંધ કરી દે વ ું
૧૦ નેપહકન કરતાું સેતનટરી પેડ
ને વધારે પસુંદ કરવ ું
85
ANSWER KEY
QUE ANS QUE ANS

1 B 11 D
2 C 12 C
3 A 13 B
4 C 14 D
5 C 15 C
6 B 16 A
7 B 17 D
8 D 18 C
9 A 19 A
10 D 20 D
SR. MARKS CLASSIFICATION

NO.
1 0-6 POOR
2 7-13 AVERAGE
3 14-20 GOOD
ATTITUDE SCALE
1. POSITIVE STATEMENTS-2,3,6,8,10
2. NEGATIVE STATEMENTS-1,4,5,7,9
 POSITIVE SCORE-5,4,3,2,1
 NEGATIVE SCORE-1,2,3,4,5
SR SCORE CLASSIFICATION
NO.
1 10-30 Unfavourable Attitude
2 31-50 Favourable Attitude
86
APPENDIX-B
LETTER SEEKING PERMISSION FOR CONDUCTING PILOT STUDY IN
RURAL AREA SCHOOL
87
APPENDIX-C
LETTER SEEKING PERMISSION FOR CONDUCTING PILOT STUDY IN
URBAN AREA SCHOOL
88
APPENDIX-D
LETTER SEEKING PERMISSION FOR CONDUCTING MAIN STUDY IN
RURAL AREA SCHOOLS
89
90
APPENDIX-E
LETTER SEEKING PERMISSION FOR CONDUCTING MAIN STUDY IN

URBAN AREA SCHOOLS
91
92
APPENDIX-F
CERTIFICATE FROM STATISTICIAN
93
APPENDIX-G
CERTIFICATE FOR GUJARATI EDITING
94
APPENDIX-H
CERTIFICATE FOR ENGLISH EDITING
95
APPENDIX-I
DATA COLLECTION PLAN
SR DATE SCHOOL NAME AREA
NO.
1 10/07/2021 Sarvajanik, Vidhyalay, Barejadi, Ahmedabad RURAL
2 09/07/2021 Vimal Vidhyavihar, Anasan, Ahmedabad
3 08/07/2021 Vishwabharti School, Gurukul, Ahmedabad URBAN
4 13/07/2021 H.B. Kapadiya High school, Delhi Darwaja,

Ahmedabad
96
APPENDIX-J
LIST OF TOOL VALIDATORS
SR. NAME OF THE DESIGNATION INSTITUTE

NO EXPERT
AMC MET Nursing School

1 Ms. Rajeshree chauhan Principal V.S. General Hospital
Campus
AMC MET Nursing School

2 Ms. Archana kanojiya Assistant Professor V.S. General Hospital
Campus
GCS College Of
3 Mr. Abhinav Bhatt Assistant Professor
Nursing,Ahmedabad
Sahajanand College Of
4 Ms. Yogita Patel Assistant Professor
Nursing ,Zundal
Mendilink institute Of
5 Mr. Chetan Gupta Principal Nursing Sciences,
Ahmedabad
Ahmedabad Institute Of
6 Ms. Trupti Bhambhatt Vice Principal
Nursing, Ahmedabad
Mahavir College Of
7 Mr. Nayan Kothari Associate professor
Nursing,Vatrak
Bhagyalaxmi College Of
8 Mr. Vijay Patidar Assistant Professor
Nursing, Modasa
JG College Of Nursing,
9 Mr.Ritesh Jethi Assistant Professor
Ahmedabad
10 Dr. Shefali Patel Medical Officer Nikol UHC
11 Dr. Krupa Modi Medical Officer Stadium UHC
97
APPENDIX-K
DEMOGRAPHIC VARIABLES
Source
Sample Attain Attended
Age Education of
No. menarche Programme
inform
U1 1 1 2 1 2
U2 3 2 1 3 1
U3 3 2 1 3 1
U4 1 1 2 1 2
U5 2 2 1 2 1
U6 2 1 1 3 2
U7 2 2 2 2 2
U8 2 2 1 1 2
U9 3 2 1 3 1
U10 3 2 1 1 2
U11 1 1 1 1 2
U12 3 2 1 3 1
U13 2 1 1 1 2
U14 1 1 2 3 2
U15 2 2 1 3 2
U16 1 1 1 2 1
U17 2 2 1 3 2
U18 1 1 2 1 2
U19 2 2 1 3 2
U20 3 2 1 3 1
U21 2 1 1 3 1
U22 2 1 1 1 2
U23 2 2 1 2 2
U24 1 1 2 1 2
U25 3 2 1 3 1
U26 2 1 1 3 2
U27 1 1 2 1 2
U28 2 2 1 3 1
U29 3 2 1 3 2
U30 3 2 1 2 2
U31 2 2 1 3 2
U32 2 1 2 3 1
U33 2 2 1 2 2
U34 3 2 1 3 2
U35 1 1 2 1 2
U36 3 2 1 3 1
U37 2 1 1 3 2
U38 2 2 1 1 2
U39 1 1 2 3 2
U40 1 1 2 3 1
98
Source
Age Education of
inform
U41 2 2 1 2 1
U42 1 1 2 3 2
U43 1 1 2 3 2
U44 3 2 1 2 2
U45 2 2 1 1 2
U46 1 1 2 3 2
U47 2 2 1 3 2
U48 1 1 2 3 2
U49 2 1 1 1 2
U50 3 2 1 2 1
U51 2 2 1 1 2
U52 2 2 1 3 1
U53 3 2 1 3 2
U54 1 1 1 1 2
U55 2 2 1 1 2
U56 2 1 1 2 2
U57 2 2 1 3 1
U58 2 1 1 3 2
U59 1 1 1 2 2
U60 2 1 1 1 2
U61 2 2 1 2 1
U62 3 2 1 3 2
U63 2 2 1 3 1
U64 2 1 1 1 2
U65 2 2 1 3 2
U66 3 2 1 3 2
U67 2 2 1 3 2
U68 1 1 2 1 2
U69 2 1 1 3 1
U70 2 2 1 2 1
U71 1 1 1 2 2
U72 1 1 1 2 2
U73 2 1 1 3 2
U74 1 1 2 3 1
U75 3 2 1 1 1
U76 2 2 1 2 2
U77 2 2 1 2 2
U78 2 2 1 3 2
U79 3 2 1 1 2
U80 2 2 1 3 2
U81 2 1 1 2 2
U82 1 1 2 3 1
U83 2 1 1 1 2
U84 1 1 2 3 2
U85 2 2 1 3 1
99
Source
Age Education of
inform
U86 3 2 1 1 2
U87 2 1 1 3 2
U88 2 2 1 2 1
U89 1 1 2 1 2
U90 2 1 1 3 2
U91 2 2 1 3 2
U92 1 1 1 2 2
U93 2 2 1 1 2
U94 2 2 1 3 2
U95 3 2 1 2 2
U96 2 2 1 1 2
U97 2 2 1 3 1
U98 2 2 1 1 1
U99 2 1 1 3 2
U100 1 1 2 2 2
R1 1 1 2 1 2
R2 3 2 1 3 1
R3 3 2 1 3 2
R4 1 1 2 1 2
R5 2 2 1 2 2
R6 2 1 1 1 2
R7 1 1 2 2 2
R8 2 2 1 1 2
R9 3 2 1 3 1
R10 3 2 1 1 2
R11 1 1 2 1 2
R12 3 2 1 2 1
R13 2 1 1 1 2
R14 1 1 2 1 2
R15 2 2 1 3 2
R16 1 1 1 2 2
R17 2 2 1 1 2
R18 1 1 2 1 2
R19 2 2 1 1 2
R20 3 2 1 2 2
R21 1 1 2 3 1
R22 2 1 1 1 2
R23 2 2 1 2 2
R24 1 1 2 1 2
R25 3 2 1 1 1
R26 2 1 1 3 2
R27 1 1 2 1 2
R28 2 2 1 1 2
R29 3 2 1 2 2
R30 3 2 1 1 2
100
Source
Age Education of
inform
R31 1 1 1 1 2
R32 2 1 2 3 1
R33 2 2 1 2 2
R34 3 2 1 1 2
R35 1 1 2 1 2
R36 3 2 1 3 1
R37 2 1 1 3 2
R38 2 2 1 1 2
R39 1 1 2 2 2
R40 1 1 2 1 2
R41 2 2 1 2 1
R42 1 1 2 1 2
R43 1 1 2 3 2
R44 3 2 1 2 2
R45 2 2 1 1 2
R46 1 1 2 3 2
R47 2 2 1 1 2
R48 1 1 2 3 2
R49 2 1 1 1 2
R50 3 2 1 2 1
R51 2 2 1 1 2
R52 2 2 1 1 2
R53 3 2 1 3 2
R54 1 1 1 1 2
R55 1 1 2 1 2
R56 2 1 1 2 2
R57 2 2 1 3 1
R58 2 1 1 1 2
R59 1 1 1 2 2
R60 2 1 1 1 2
R61 2 2 1 1 2
R62 3 2 1 3 2
R63 2 2 1 1 1
R64 2 1 1 1 2
R65 2 2 1 2 2
R66 3 2 1 3 2
R67 2 2 1 3 2
R68 1 1 2 1 2
R69 2 1 1 1 1
R70 2 2 1 2 1
R71 1 1 1 1 2
R72 1 1 1 2 2
R73 2 1 1 1 2
R74 1 1 2 3 2
R75 3 2 1 1 1
101
Source
Age Education of
inform
R76 2 2 1 2 2
R77 2 2 1 2 2
R78 2 2 1 1 2
R79 3 2 1 1 2
R80 2 2 1 3 2
R81 2 1 1 2 2
R82 1 1 2 1 1
R83 2 1 1 1 2
R84 1 1 2 1 2
R85 2 2 1 3 2
R86 3 2 1 1 2
R87 2 1 1 1 2
R88 2 2 1 2 1
R89 1 1 2 1 2
R90 2 1 1 3 2
R91 2 2 1 1 2
R92 1 1 1 2 2
R93 2 2 1 1 2
R94 2 2 1 1 2
R95 3 2 1 2 2
R96 2 2 1 1 2
R97 2 2 1 3 1
R98 1 1 2 1 2
R99 2 1 1 1 2
R100 1 1 2 2 2
CODING FOR DEMOGRAPHIC DATA:-
Age- 1-11-13 years, 2-14-16 years and 3- 17-18 years
Education:- 1 -Std-7-9, 2- Std-10-12
Did you Attain menarche:-1-Yes, 2- No
Source of Information:- 1. Family, 2. Friends and 3.social media
Attended any Programme:-1-Yes, 2-No
102
APPENDIX-L
MASTER SHEET FOR KNOWLEDGE SCORE
Sample
Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 Q10 Q11 Q12 Q13 Q14 Q15 Q16 Q17 Q18 Q19 Q20 TOTAL
no
U1 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 0 13
U2 1 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 1 1 1 16
U3 1 1 1 1 1 0 1 0 1 1 0 1 0 1 1 1 0 1 1 1 15
U4 1 0 1 1 0 1 0 0 1 0 1 1 1 1 0 1 1 0 1 1 13
U5 1 0 1 1 0 0 1 0 1 1 1 1 1 0 1 1 1 0 1 1 14
U6 1 0 1 0 1 0 1 1 0 1 1 1 0 1 1 1 1 1 0 1 14
U7 1 0 1 1 0 1 0 0 1 0 1 1 1 1 1 1 0 1 0 1 13
U8 1 1 1 0 1 0 1 0 0 1 0 1 1 1 1 0 1 0 1 0 12
U9 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 1 1 0 1 15
U10 1 1 1 1 1 0 1 1 1 1 0 1 0 1 0 1 0 1 1 1 15
U11 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 0 13
U12 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
U13 1 1 1 0 1 0 1 0 1 1 1 0 1 1 0 1 1 0 1 0 13
U14 1 0 1 1 0 1 0 1 1 0 1 1 0 1 1 1 1 1 0 1 14
U15 1 1 1 1 0 0 1 0 1 1 0 1 1 0 1 1 1 0 1 1 14
U16 1 1 1 0 1 0 1 1 0 1 0 1 1 1 0 1 1 0 1 1 14
U17 1 0 1 1 1 1 0 1 1 0 1 1 0 1 0 1 0 1 0 1 13
U18 1 1 1 0 1 1 1 0 0 0 1 0 1 0 1 1 1 0 1 0 12
U19 1 1 1 1 1 0 1 1 1 0 1 1 1 1 1 1 0 1 0 1 16
103
Sample
no
U20 1 1 1 1 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 1 14
U21 1 1 1 0 1 0 1 0 1 1 1 0 1 1 1 0 1 0 1 0 13
U22 1 0 1 1 0 1 0 1 1 0 1 1 0 1 0 1 1 1 0 1 13
U23 1 1 1 0 1 1 1 1 0 1 0 1 1 1 1 0 1 1 1 0 15
U24 1 1 1 0 1 1 1 0 0 0 1 0 1 0 1 1 1 0 1 0 12
U25 1 1 1 1 1 0 1 1 1 1 0 1 0 1 0 1 0 1 1 1 15
U26 1 0 1 1 0 1 0 0 1 0 0 1 1 1 0 1 1 1 0 1 12
U27 1 1 1 0 1 0 1 1 0 1 0 0 1 1 1 0 1 0 1 0 12
U28 1 0 1 1 0 1 1 0 0 1 1 1 1 0 1 1 1 1 1 1 15
U29 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
U30 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 1 1 0 1 15
U31 1 0 1 0 1 0 1 1 0 1 0 1 0 1 1 1 1 0 1 0 12
U32 1 1 1 1 0 1 1 0 1 0 1 1 0 1 1 1 1 1 0 1 15
U33 1 1 1 0 1 1 1 1 0 1 0 1 1 1 1 0 0 1 1 0 14
U34 1 1 1 1 1 0 1 0 1 1 0 1 0 1 0 1 1 1 1 1 15
U35 1 0 1 1 0 0 1 1 0 1 0 1 1 0 1 1 1 0 1 1 13
U36 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 1 1 0 1 15
U37 1 1 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 0 1 0 12
U38 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 1 1 1 0 1 14
U39 1 0 1 1 0 1 1 0 1 1 0 1 0 1 1 1 0 1 0 1 13
U40 1 1 1 0 1 0 1 1 0 1 0 0 1 1 1 0 1 0 1 0 12
U41 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
U42 1 1 1 0 1 0 1 0 0 1 0 0 1 1 1 0 1 0 1 1 12
104
Sample
no
U43 1 0 1 1 0 1 1 0 0 1 1 1 1 1 0 1 1 0 1 1 14
U44 1 1 1 1 1 1 0 1 1 1 0 1 1 0 1 1 0 1 1 1 16
U45 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 1 1 0 1 15
U46 1 0 1 0 1 0 1 1 0 1 0 1 0 1 1 1 1 0 1 0 12
U47 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 0 1 0 1 14
U48 1 0 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 0 1 1 12
U49 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 0 14
U50 1 0 1 1 0 1 0 1 1 0 1 1 0 1 0 1 0 1 0 1 12
U51 1 0 1 1 0 1 1 0 1 0 1 1 0 1 1 1 1 0 1 1 14
U52 1 1 1 0 1 0 1 1 0 1 1 1 0 1 1 0 0 1 1 1 14
U53 1 1 1 1 1 0 1 1 1 1 0 1 0 1 0 1 0 1 1 1 15
U54 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 1 0 1 1 14
U55 1 1 1 0 1 1 1 1 0 1 1 0 1 1 1 0 1 1 1 0 15
U56 1 0 1 1 0 0 1 0 1 1 0 1 1 1 0 1 1 1 1 1 14
U57 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
U58 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 0 14
U59 1 0 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 12
U60 1 0 1 1 0 1 0 0 1 0 1 1 0 1 0 1 1 0 1 1 12
U61 1 1 1 0 1 1 1 1 0 1 0 1 1 1 1 1 0 1 1 0 15
U62 1 1 1 1 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 1 14
U63 1 1 1 1 1 0 1 1 1 0 1 1 1 1 1 0 0 1 0 1 15
U64 1 0 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 1 0 1 12
U65 1 0 1 1 0 1 0 1 1 0 1 1 1 1 0 1 1 0 0 1 13
105
Sample
no
U66 1 1 1 0 1 0 1 1 0 1 0 1 1 1 1 0 1 1 1 0 14
U67 1 1 1 1 1 0 1 0 1 1 0 1 0 1 1 1 0 1 1 1 15
U68 1 0 1 1 1 0 1 1 0 1 1 1 1 0 0 1 1 0 1 1 14
U69 1 1 1 0 1 1 1 0 1 1 0 0 1 1 1 0 1 1 1 1 15
U70 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
U71 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 0 14
U72 1 0 1 1 0 1 0 0 1 1 0 1 0 1 0 1 1 1 0 1 12
U73 1 1 1 1 0 1 0 0 1 0 1 1 0 1 1 1 1 0 1 1 14
U74 1 0 1 0 1 0 1 1 1 0 1 1 0 1 0 1 1 0 1 0 12
U75 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
U76 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 1 1 1 0 0 14
U77 1 0 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 1 1 13
U78 1 1 1 0 1 1 1 1 0 1 1 1 1 1 1 0 1 1 1 0 16
U79 1 1 1 1 1 0 1 0 1 1 1 1 0 1 0 1 0 1 1 1 15
U80 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 1 1 0 1 15
U81 1 0 1 1 0 1 1 0 1 1 0 1 1 1 0 1 1 0 1 1 14
U82 1 1 1 0 1 1 1 0 1 1 1 0 1 1 0 1 1 1 1 0 15
U83 1 0 1 0 1 0 1 1 1 0 1 1 0 1 1 1 1 0 1 0 13
U84 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
U85 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 0 14
U86 1 0 1 1 0 1 0 1 1 0 1 1 1 1 0 1 1 1 1 1 15
U87 1 1 1 0 1 1 1 1 0 1 0 1 1 1 1 0 1 1 1 0 15
U88 1 1 1 1 1 0 1 0 1 1 1 1 0 1 0 1 0 1 1 1 15
106
Sample
no
U89 1 0 1 1 0 1 1 1 0 1 0 1 1 0 1 1 1 0 1 1 14
U90 1 1 1 0 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 14
U91 1 0 1 1 0 1 0 1 1 0 0 1 0 1 1 1 1 1 0 1 13
U92 1 0 1 0 1 0 1 1 0 1 1 1 0 1 0 1 1 0 1 0 12
U93 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
U94 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 1 1 0 0 1 13
U95 1 0 1 1 1 1 0 1 1 1 1 1 0 1 0 1 0 1 0 1 14
U96 1 1 1 0 1 0 1 1 0 1 0 1 1 1 1 0 1 1 1 0 14
U97 1 1 1 1 1 0 1 0 1 1 1 1 0 1 0 1 0 1 1 1 15
U98 1 0 1 1 0 1 1 1 0 1 0 1 1 1 0 1 1 1 1 1 15
U99 1 1 1 0 1 0 1 0 0 1 1 0 1 1 1 1 1 0 1 0 13
U100 1 0 1 1 0 1 0 0 1 0 1 1 0 1 0 1 1 1 0 1 12
R1 1 1 1 0 1 1 1 0 0 0 1 0 0 0 1 1 1 0 0 0 10
R2 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
R3 1 1 1 1 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 1 14
R4 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 1 0 0 1 10
R5 1 0 1 1 0 0 1 0 0 1 0 1 1 0 0 1 1 0 1 1 11
R6 1 0 1 0 1 0 1 1 0 0 0 1 0 1 0 1 1 0 1 0 10
R7 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 0 1 0 1 10
R8 1 1 1 0 1 0 1 0 0 1 0 0 1 1 0 0 1 0 1 0 10
R9 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 0 1 0 1 14
R10 1 1 1 1 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 1 14
R11 1 1 1 0 1 1 1 0 0 0 1 0 0 0 1 1 1 0 0 0 10
107
Sample
no
R12 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
R13 1 1 1 0 1 0 1 0 0 1 0 0 1 1 0 0 1 0 1 0 10
R14 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 1 0 0 1 10
R15 1 0 1 1 0 0 1 0 0 1 0 1 1 0 0 1 1 0 1 1 11
R16 1 0 1 0 1 0 1 1 0 0 0 1 0 1 0 1 1 0 0 0 9
R17 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 0 1 0 1 10
R18 1 1 1 0 1 1 1 0 0 0 1 0 0 0 1 1 1 0 0 0 10
R19 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 0 1 0 1 14
R20 1 1 1 1 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 1 14
R21 1 1 1 0 1 0 1 0 0 1 0 0 1 1 0 0 1 0 1 0 10
R22 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 1 0 0 1 10
R23 1 1 1 0 1 0 1 1 0 1 0 1 0 1 1 0 0 1 1 0 12
R24 1 1 1 0 1 1 1 0 0 0 1 0 0 0 1 1 1 0 0 0 10
R25 1 1 1 1 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 1 14
R26 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 0 1 0 1 10
R27 1 1 1 0 1 0 1 0 0 1 0 0 1 1 0 0 1 0 1 0 10
R28 1 0 1 1 0 0 1 0 0 1 0 1 1 0 0 1 1 0 1 1 11
R29 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
R30 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 0 1 0 1 14
R31 1 0 1 0 1 0 1 1 0 0 0 1 0 1 0 1 1 0 0 0 9
R32 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 1 0 0 1 10
R33 1 1 1 0 1 0 1 1 0 1 0 1 0 1 1 0 0 1 1 0 12
R34 1 1 1 1 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 1 14
108
Sample
no
R35 1 0 1 1 0 0 1 0 0 1 0 1 1 0 0 1 1 0 1 1 11
R36 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 0 1 0 1 14
R37 1 0 1 0 1 0 1 1 0 0 0 1 0 1 0 1 1 0 0 0 9
R38 1 1 1 0 1 1 1 0 0 0 1 0 0 0 1 1 1 0 0 0 10
R39 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 0 1 0 1 10
R40 1 1 1 0 1 0 1 0 0 1 0 0 1 1 0 0 1 0 1 0 10
R41 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
R42 1 1 1 0 1 0 1 0 0 1 0 0 1 1 0 0 1 0 1 0 10
R43 1 0 1 1 0 0 1 0 0 1 0 1 1 0 0 1 1 0 1 1 11
R44 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
R45 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 0 1 0 1 14
R46 1 0 1 0 1 0 1 1 0 0 0 1 0 1 0 1 1 0 0 0 9
R47 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 0 1 0 1 14
R48 1 0 1 0 1 0 1 1 0 0 0 1 0 1 0 1 1 0 1 0 10
R49 1 1 1 0 1 1 1 0 0 0 1 0 0 0 1 1 1 0 0 0 10
R50 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 0 1 0 1 10
R51 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 1 0 0 1 10
R52 1 1 1 0 1 0 1 1 0 1 0 1 0 1 1 0 0 1 1 0 12
R53 1 1 1 1 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 1 14
R54 1 0 1 1 0 0 1 0 0 1 0 1 1 0 0 1 1 0 1 1 11
R55 1 1 1 0 1 0 1 0 0 1 0 0 1 1 0 0 1 0 1 0 10
R56 1 0 1 1 0 0 1 0 0 1 0 1 1 0 0 1 1 0 1 1 11
R57 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
109
Sample
no
R58 1 1 1 0 1 1 1 0 0 0 1 0 0 0 1 1 1 0 0 0 10
R59 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 0 1 0 1 10
R60 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 1 0 0 1 10
R61 1 1 1 0 1 0 1 1 0 1 0 1 0 1 1 0 0 1 1 0 12
R62 1 1 1 1 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 1 14
R63 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 0 1 0 1 14
R64 1 0 1 0 1 0 1 1 0 0 0 1 0 1 0 1 1 0 0 0 9
R65 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 1 0 0 1 10
R66 1 1 1 0 1 0 1 1 0 1 0 1 0 1 1 0 0 1 1 0 12
R67 1 1 1 1 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 1 14
R68 1 0 1 1 0 0 1 0 0 1 0 1 1 0 0 1 1 0 1 1 11
R69 1 1 1 0 1 0 1 0 0 1 0 0 1 1 0 0 1 0 1 0 10
R70 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
R71 1 1 1 0 1 1 1 0 0 0 1 0 0 0 1 1 1 0 0 0 10
R72 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 0 1 0 1 10
R73 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 1 0 1 1 11
R74 1 0 1 0 1 0 1 1 0 0 0 1 0 1 0 1 1 0 0 0 9
R75 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
R76 1 1 1 0 1 1 1 0 0 0 1 0 0 0 1 1 1 0 0 0 10
R77 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 0 1 0 1 10
R78 1 1 1 0 1 0 1 1 0 1 0 1 0 1 1 0 0 1 1 0 12
R79 1 1 1 1 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 1 14
R80 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 0 1 0 1 14
110
Sample
no
R81 1 0 1 1 0 0 1 0 0 1 0 1 1 0 0 1 1 0 1 1 11
R82 1 1 1 0 1 0 1 0 0 1 0 0 1 1 0 0 1 0 1 0 10
R83 1 0 1 0 1 0 1 1 0 0 0 1 0 1 0 1 1 0 1 0 10
R84 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
R85 1 1 1 0 1 1 1 0 0 0 1 0 0 0 1 1 1 0 0 0 10
R86 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 0 1 0 1 10
R87 1 1 1 0 1 0 1 1 0 1 0 1 0 1 1 0 0 1 1 0 12
R88 1 1 1 1 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 1 14
R89 1 0 1 1 0 0 1 0 0 1 0 1 1 0 0 1 1 0 1 1 11
R90 1 1 1 0 1 0 1 0 0 1 0 0 1 1 0 0 1 0 1 0 10
R91 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 1 0 0 1 10
R92 1 0 1 0 1 0 1 1 0 0 0 1 0 1 0 1 1 0 1 0 10
R93 1 1 1 1 1 1 0 1 0 1 0 1 1 0 1 1 0 1 1 1 15
R94 1 1 1 0 1 1 1 0 0 0 1 0 0 0 1 1 1 0 0 0 10
R95 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 0 1 0 1 10
R96 1 1 1 0 1 0 1 1 0 1 0 1 0 1 1 0 0 1 1 0 12
R97 1 1 1 1 1 0 1 0 1 1 0 1 0 1 0 1 0 1 1 1 14
R98 1 0 1 1 0 0 1 0 0 1 0 1 1 0 0 1 1 0 1 1 11
R99 1 1 1 0 1 0 1 0 0 1 0 0 1 1 0 0 1 0 1 0 10
R100 1 0 1 1 0 1 0 0 1 0 0 1 0 1 0 1 1 0 0 1 10
111
APPENDIX-M
MASTER SHEET FOR ATTITUDE SCALE
Sample
S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 TOTAL
no
U1 5 4 4 3 5 4 4 4 3 4 40
U2 5 3 5 4 3 5 4 3 4 3 39
U3 5 4 3 4 3 4 4 3 3 5 38
U4 5 3 4 3 4 4 4 4 3 4 38
U5 5 3 4 3 3 5 3 4 5 3 38
U6 5 3 4 4 4 4 3 5 5 5 42
U7 5 4 5 4 4 3 4 4 3 4 40
U8 5 5 4 5 4 5 4 3 4 4 43
U9 5 4 5 4 5 4 5 4 4 5 45
U10 5 4 5 4 5 4 4 5 4 5 45
U11 5 3 4 3 5 4 4 4 3 4 39
U12 5 5 5 5 3 5 4 5 4 4 45
U13 5 3 4 4 4 3 4 3 4 4 38
U14 5 3 4 3 4 3 5 4 4 3 38
U15 5 3 5 4 5 5 3 4 4 4 42
U16 5 3 4 4 4 4 3 5 5 5 42
U17 5 4 5 4 4 3 4 4 4 4 41
U18 5 3 4 4 5 4 4 4 3 4 40
U19 5 4 5 4 5 4 4 5 4 4 44
U20 5 4 5 4 5 4 4 5 3 5 44
U21 5 3 4 4 4 3 4 3 4 4 38
U22 5 3 4 4 4 4 5 4 5 4 42
U23 5 4 5 5 5 4 3 4 5 4 44
U24 5 3 4 3 5 4 4 4 3 4 39
U25 5 4 5 4 4 4 5 5 4 5 45
U26 5 4 5 4 4 3 4 4 4 4 41
U27 5 3 4 3 4 3 4 4 4 4 38
U28 5 4 5 4 5 5 5 4 4 4 45
U29 5 5 5 4 3 5 4 5 4 5 45
U30 5 4 5 4 5 4 5 4 4 5 45
U31 5 3 4 3 4 4 3 4 3 5 38
U32 5 4 4 5 4 4 4 5 3 4 42
U33 5 4 5 4 5 4 5 4 4 4 44
U34 5 4 5 4 5 4 3 5 5 5 45
U35 5 3 5 4 5 5 3 4 5 4 43
U36 5 4 5 4 5 4 5 4 5 4 45
112
Sample
no
U37 5 3 4 4 4 4 3 4 3 4 38
U38 5 3 4 4 5 4 4 4 5 4 42
U39 5 4 5 4 4 4 4 4 4 4 42
U40 5 3 4 4 4 3 4 3 4 4 38
U41 5 5 5 4 5 5 3 5 4 4 45
U42 5 3 4 4 4 3 3 4 4 4 38
U43 5 3 5 4 5 5 4 4 4 4 43
U44 5 5 5 4 5 5 4 5 4 4 46
U45 5 4 5 4 5 4 4 5 4 4 44
U46 5 3 4 4 4 4 4 3 4 3 38
U47 5 4 5 4 5 5 4 5 4 4 45
U48 5 3 4 4 4 4 4 3 3 4 38
U49 5 4 4 4 5 4 4 4 5 4 43
U50 5 4 5 4 4 3 4 4 3 4 40
U51 5 4 4 5 4 4 5 4 4 4 43
U52 5 4 5 4 5 4 4 4 5 4 44
U53 5 4 5 4 5 4 3 5 5 5 45
U54 5 3 5 4 5 5 3 4 5 4 43
U55 5 4 4 4 4 4 5 5 5 4 44
U56 5 3 5 4 5 5 4 4 4 4 43
U57 5 5 5 4 5 4 4 5 4 4 45
U58 5 3 4 5 5 4 4 4 4 4 42
U59 5 4 5 4 4 4 4 4 4 4 42
U60 5 3 4 4 4 4 4 3 4 4 39
U61 5 4 5 4 5 4 5 4 4 4 44
U62 5 4 5 4 5 4 4 5 4 5 45
U63 5 4 5 4 5 5 4 5 4 4 45
U64 5 3 4 4 4 4 3 4 3 4 38
U65 5 3 4 4 4 4 4 3 5 4 40
U66 5 4 5 4 5 4 3 4 5 4 43
U67 5 4 5 4 5 4 4 5 3 5 44
U68 5 4 5 3 5 5 4 4 4 4 43
U69 5 3 4 4 4 5 5 4 5 4 43
U70 5 5 5 4 5 4 4 5 4 4 45
U71 5 3 4 4 5 4 5 4 5 4 43
U72 5 4 5 4 4 3 4 4 5 4 42
U73 5 3 4 5 4 4 5 3 5 4 42
U74 5 3 4 5 4 4 4 4 3 3 39
U75 5 5 5 4 5 4 4 5 4 4 45
U76 5 3 4 4 5 4 5 4 4 4 42
U77 5 4 5 4 4 3 4 4 3 4 40
113
Sample
no
U78 5 4 5 4 5 4 5 4 5 4 45
U79 5 4 5 4 5 4 4 5 3 5 44
U80 5 4 5 4 5 4 5 4 5 4 45
U81 5 3 5 4 5 5 3 4 4 4 42
U82 5 3 4 4 4 5 4 5 4 4 42
U83 5 3 4 3 4 4 4 4 4 3 38
U84 5 4 5 4 5 5 4 5 4 4 45
U85 5 3 4 4 5 4 5 4 4 4 42
U86 5 4 5 4 4 5 4 4 4 4 43
U87 5 4 5 5 5 4 4 4 4 4 44
U88 5 4 5 4 5 4 4 5 4 5 45
U89 5 3 5 4 5 5 4 4 5 4 44
U90 5 4 4 3 5 4 5 5 4 4 43
U91 5 3 4 4 4 4 4 3 4 4 39
U92 5 3 4 4 4 4 3 4 4 3 38
U93 5 4 5 4 5 5 4 5 4 4 45
U94 5 3 4 3 5 4 4 4 3 4 39
U95 5 4 5 4 4 4 5 4 4 4 43
U96 5 4 5 4 5 4 4 4 4 4 43
U97 5 4 5 4 5 4 5 5 3 5 45
U98 5 3 5 5 5 5 3 4 5 4 44
U99 5 3 4 3 4 4 3 3 4 4 37
U100 5 3 4 3 4 4 3 5 3 4 38
R1 5 3 4 3 5 4 2 4 3 4 37
R2 5 5 5 4 5 5 4 5 4 4 46
R3 5 4 5 4 5 4 2 5 3 5 42
R4 5 3 4 3 4 4 3 3 3 4 36
R5 5 3 5 2 5 5 3 4 3 4 39
R6 5 3 4 3 4 4 3 3 3 3 35
R7 5 4 5 4 4 3 4 4 2 4 39
R8 5 3 4 3 4 3 3 3 2 4 34
R9 5 4 5 4 5 4 4 4 4 4 43
R10 5 4 5 4 5 4 2 5 3 5 42
R11 5 3 4 3 5 4 2 4 3 4 37
R12 5 5 5 4 5 5 4 5 4 4 46
R13 5 3 4 3 4 3 3 3 2 4 34
R14 5 3 4 3 4 3 3 3 3 4 35
R15 5 3 5 2 5 5 3 4 4 4 40
R16 5 3 4 3 4 4 3 3 3 3 35
R17 5 4 5 4 4 4 3 4 2 4 39
R18 5 3 4 3 5 4 2 4 3 4 37
114
Sample
no
R19 5 4 5 4 5 4 4 4 4 4 43
R20 5 4 5 4 5 4 2 5 3 5 42
R21 5 3 4 3 4 3 3 3 2 4 34
R22 5 3 4 3 4 4 3 3 3 4 36
R23 5 4 5 2 5 4 3 4 3 4 39
R24 5 3 4 3 5 4 2 4 3 4 37
R25 5 4 5 4 5 4 2 5 3 5 42
R26 5 4 5 4 4 3 4 4 2 4 39
R27 5 3 4 3 4 3 3 3 2 4 34
R28 5 3 5 2 5 5 3 4 4 4 40
R29 5 5 5 4 5 5 4 5 4 4 46
R30 5 4 5 4 5 4 4 4 4 4 43
R31 5 3 4 3 4 4 3 3 3 3 35
R32 5 3 4 3 4 4 3 3 3 4 36
R33 5 4 5 2 5 4 3 4 3 4 39
R34 5 4 5 4 5 4 2 5 3 5 42
R35 5 3 5 2 5 5 3 4 4 4 40
R36 5 4 5 4 5 4 4 4 4 4 43
R37 5 3 4 3 4 4 3 3 3 3 35
R38 5 3 4 3 5 4 2 4 3 4 37
R39 5 4 5 4 4 3 4 4 2 4 39
R40 5 3 4 3 4 3 3 3 2 4 34
R41 5 5 5 4 5 5 4 5 4 4 46
R42 5 3 4 3 4 3 3 3 2 4 34
R43 5 3 5 2 5 5 3 4 4 4 40
R44 5 5 5 4 5 5 4 5 4 4 46
R45 5 4 5 4 5 4 4 4 4 4 43
R46 5 3 4 3 4 4 3 3 3 3 35
R47 5 4 5 4 5 4 4 4 4 4 43
R48 5 3 4 3 4 4 3 3 3 3 35
R49 5 3 4 3 5 4 2 4 3 4 37
R50 5 4 5 4 4 3 4 4 2 4 39
R51 5 3 4 3 4 4 3 3 3 4 36
R52 5 4 5 2 5 4 3 4 3 4 39
R53 5 4 5 4 5 4 2 5 3 5 42
R54 5 3 5 2 5 5 3 4 4 4 40
R55 5 3 4 3 4 3 3 3 2 4 34
R56 5 3 5 2 5 5 3 4 4 4 40
R57 5 5 5 4 5 5 4 5 4 4 46
R58 5 3 4 3 5 4 2 4 3 4 37
R59 5 4 5 4 4 3 4 4 2 4 39
115
Sample
no
R60 5 3 4 3 4 4 3 3 3 4 36
R61 5 4 5 2 5 4 3 4 3 4 39
R62 5 4 5 4 5 4 2 5 3 5 42
R63 5 4 5 4 5 4 4 4 4 4 43
R64 5 3 4 3 4 4 3 3 3 3 35
R65 5 3 4 3 4 4 3 3 3 4 36
R66 5 4 5 2 5 4 3 4 3 4 39
R67 5 4 5 4 5 4 2 5 3 5 42
R68 5 3 5 2 5 5 3 4 4 4 40
R69 5 3 4 3 4 3 3 3 2 4 34
R70 5 5 5 4 5 5 4 5 4 4 46
R71 5 3 4 3 5 4 2 4 3 4 37
R72 5 4 5 4 4 3 4 4 2 4 39
R73 5 3 4 3 4 4 3 3 3 4 36
R74 5 3 4 3 4 4 3 3 3 3 35
R75 5 5 5 4 5 5 4 5 4 4 46
R76 5 3 4 3 5 4 2 4 3 4 37
R77 5 4 5 4 4 3 4 4 2 4 39
R78 5 4 5 2 5 4 3 4 3 4 39
R79 5 4 5 4 5 4 2 5 3 5 42
R80 5 4 5 4 5 4 4 4 4 4 43
R81 5 3 5 2 5 5 3 4 4 4 40
R82 5 3 4 3 4 3 3 3 2 4 34
R83 5 3 4 3 4 4 3 3 3 3 35
R84 5 5 5 4 5 5 4 5 4 4 46
R85 5 3 4 3 5 4 2 4 3 4 37
R86 5 4 5 4 4 3 4 4 2 4 39
R87 5 4 5 2 5 4 3 4 3 4 39
R88 5 4 5 4 5 4 2 5 3 5 42
R89 5 3 5 2 5 5 3 4 4 4 40
R90 5 3 4 3 4 3 3 3 2 4 34
R91 5 3 4 3 4 4 3 3 3 4 36
R92 5 3 4 3 4 4 3 3 3 3 35
R93 5 5 5 4 5 5 4 5 4 4 46
R94 5 3 4 3 5 4 2 4 3 4 37
R95 5 4 5 4 4 3 4 4 2 4 39
R96 5 4 5 2 5 4 3 4 3 4 39
R97 5 4 5 4 5 4 2 5 3 5 42
R98 5 3 5 2 5 5 3 4 4 4 40
R99 5 3 4 3 4 3 3 3 2 4 34
R100 5 3 4 3 4 4 3 3 3 4 36
116
119
ABSTRACT
A Comparative study to assess the knowledge and attitude regarding use of
sanitary pads among the adolescents girls studying in selected schools of rural and
urban area of Ahmedabad The objectives of the study were: 1. To assess and compare
the knowledge regarding Use of sanitary pads among the adolescent girls studying in
selected schools of rural and urban areas of Ahmadabad. 2. To assess and compare
the attitude regarding Use of sanitary pads among the adolescent girls studying in
selected schools of rural and urban areas of Ahmadabad. 3. To find out the
correlation between the knowledge and attitude regarding Use of sanitary pads among
the adolescent girls studying in selected schools of rural and urban areas of
Ahmadabad. 4. To find out the association between selected demographic variables
and knowledge regarding Use of sanitary pads among the adolescent girls studying in
selected schools of rural and urban areas of Ahmadabad . And 5. To find out the
association between selected demographic variables and attitude regarding Use of
A Comparative descriptive Survey Research approach used. The investigator
has used Convenient Sampling Techniques for selecting 200 samples. A Structured
Knowledge Questionnaire and Likert’s Attitude Scale were prepared to assess the
Knowledge and Attitude of the samples. The investigator has validated the tool by 11
experts of psychiatric field. Reliability of Structured Knowledge tool was done by
Karl’s Pearson formula was 0.8 and Likert’s attitude tool was done by Karl’s Pearson
formula was 0.804. Descriptive and Inferential statistics were used to analysis of the
data.
The Pilot study was conducted from Rural area kashindra girls school,
Ahmedabad. And from urban area sadhana vinay mandir school, Ahmedabad The
data was collected in rural area school on 12th Jun 2021, and in Urban area schools on
14th Jun 2021. According to analysis of the data , the majority findings were the mean
knowledge score of urban Adolescent girls 14.1(70.5%) is grater then the mean
knowledge score of rural Adolescent girls 11.5(57.5%) The mean attitude score of
urban Adolescent girls 42.40(84.8%) is grater then the mean attitude score of rural
Adolescent girls 37(74%), There were 70% of Adolescent girls from rural area having
average knowledge and 30% had good knowledge, where as in urban area, 50%
119
Adolescent girls had poor knowledge and 50% Adolescent girls had average
knowledge. And all girls both rural and urban having positive attitude.
In Final study Out of 200 sample Majority of the sample in rural area out of
100 samples, in age, 31 (13%) were in 11-13 years, 49 (49%) in 14-16 years and
20(20%) in 17-18. In education 49(49%) were studying in class 7 – 9 std and 51(51 %)
were in class 10 – 12 std. In data related to attainment of menarche 75(75%) samples
were responded yes and 25(25%) samples responded no. In source of information
54(54%) participants had family as their source of information, 24(24%) were having
friends and 22(22%) were having social media as source of information. In attended
program related to use of sanitary pads 17(17%) responded yes and 83(83%)
responded no. Whereas in urban area out of 100 samples, in age, 26 (26%) were in
11-13 years, 54 (54%) in 14-16 years and 20(20%) in 17-18. In education 45(49%)
were studying in class 7 – 9 std and 55(55 %) were in class 10 – 12 std. In data related
to attainment of menarche 79(79%) samples were responded yes and 21(21%) samples
responded no. In source of information 28(28%) participants had family as their
source of information, 22(22%) were having friends and 50(50%) were having social
media as source of information. In attended program related to use of sanitary pads
28(28%) responded yes and 72(72%) responded no. Mean knowledge score of rural
adolescents girls was 11.48 while Mean knowledge score of urban adolescents girls
was 13.87 and the difference was 2.39. The Standard Deviation (SD) of Rural and
urban adolescents girls in knowledge was 1.97 and 1.18 respectively. The calculated
‘t’ value is 10.386 which higher than the tabulated ‘t’ value 1.64,which indicates the
Significant difference in knowledge score of rural and urban adolescents girls. Mean
Attitude score of rural adolescents girls was 38.97 while Mean attitude score of urban
adolescents girls was 42.06 and the difference was 3.09. The Standard Deviation (SD)
of Rural and urban adolescents girls in knowledge was 3.62 and 2.90 respectively. The
calculated ‘t’ value is 6.912 which higher than the tabulated ‘t’ value 1.64,which
indicates the Significant difference in attitude score of rural and urban adolescents
girls. The Correlation Coefficient was obtained using Karl Pearson's formula which
yielded r=0.911 for rural adolescent girls. It suggests Positive Correlation between the
Knowledge Score and Attitude Score of Samples and for urban adolescents girls
r=0.752. It suggests Positive Correlation between the Knowledge Score and Attitude
Score of Samples. Association of selected Demographic Variables with the
120
Knowledge and Attitude score was computed using Chi Square test and it showed that
there is significant association between them. Data demonstrated that there was
significant difference the Knowledge and Attitude on use of sanitary pads. Hence it is
proved that the urban adolescents girls having more knowledge than rural adolescents
girls.
Suhani Joshi
121

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A COMPARATIVE STUDY TO ASSESS THE KNOWLEDGE AND

ATTITUDE REGARDING USE OF SANITARY PADS

MS. SUHANI ANILKUMAR JOSHI

RESEARCH GUIDE RESEARCH CO GUIDE

Ms. Sejal Shukla Mr. Ashok Sharma

MS. SUHANI A JOSHI

A DISSERTATION SUBMITTED TO GUJARAT UNIVERSITY,

MS. SUHANI JOSHI

Shrey Institute of Nursing & Allied Sciences, Ahmedabad.

SUBMITTED FOR PARTIAL FULFILLMENT OF THE

Roll No:- Ms. Rina Mathew

THIS THESIS IS DEDICATED TO MY BELOVED

3.1 List of selected areas of research study 25

4.4.2 Correlation between knowledge score and attitude score among 51

1.1 Conceptual Framework on Health Belief Model 11

4.1 Graph showing Frequency wise distribution of Demographic 40

4.2 Graph Showing the Knowledge level of rural and urban 42

4.5 Scattered diagram showing the correlation between knowledge 52

A Research Tool on Use of sanitary pads 71

G Certificate of Gujarati Editing 94

I Data Collection plan 96

J List of tool Validators 97

L Master data Sheet of Knowledge Score 103

M Master data Sheet of Attitude Score 112

1.8. CONCEPTUAL FRAMEWORK

Conceptual framework is the schematic representation of the study. It provides

The main components of model are:

(1) Individual perception

(2) Modified factors

(3) Likelihood of taking action

GOVT. HOSPITAL FOR MENTAL HEALTH, GUJARAT STATE

SCHOOLS OF RURAL AND URBAN AREA , AHMEDABAD

-Demographic Variables:- -Administration of

Figure-1.1:Conceptual framework based on Health Belief Bodel (Rosen stock’sand Beckers’s)

Priyanka Kumar*, S.B. Gupta, Imtiaz Danish(2018) A Study Conducted for

Vasanthi R, and Manju Bala Dash(2018) A study conducted on “Are Maintaining

Pradeep Senapathi, Hemant Kumar (2017) A comparative study of menstrual

Drakshyani Devi (2012) conducted a prospective study on menstruation in school

2.2. Literature related to knowledge and attitude regarding use of

Pooja Arugula, Suresh Kumar Paramasivam, Niharika Kanuri(2017) A study

Lynette (2014) conducted a cross sectional study about knowledge on menstruation

Soeffer et.al. (2014) conducted a descriptive qualitative study on menstrual health

Rao R.S.P et.al., (2014) conducted a study on effectiveness of reproductive health

Rose J.G.(2013) conducted a study on Attitude toward and experience with

A.J.Singh (2013) conducted a qualitative and quantitative study on reproductive

Shazly et.al.,(2013) conducted a study to assess the knowledge on menstruation and

Rajashree R. Kamble (2012) conducted a study to evaluate school – based hygiene

Section-II:- Structured Knowledge Questionnaire

Section-III:- Likert Attitude Scale

Data analysis and interpretation by using descriptive and inferential

Areas School name Sample size

Naranpura Sadhana Vinay Mandir 10

H B Kapadiya High School,

For Pilot study ( Rural)

Village School name Sample size

Kashindra Kashindra girls school, 10

Anasan Vimal Vidhyavihar, Anasan 50

H B Kapadiya High Sarvajanik

DEMOGRAPHIC VARIABLES: Age, Education, Attainment of menarche, Source

DEPENDENT VARIABLE: Knowledge and attitude regarding the use of sanitary