IJNRDTH00126

© 2024 IJNRD | Volume 9, Issue 4 April 2024| ISSN: 2456-4184 | IJNRD.
ORG
A STUDY TO ASSESS THE EFFECTIVENESS

OF STRUCTURED TEACHING PROGRAM ON
KNOWLEDGE REGARDING REPRODUCTIVE
HEALTH AMONG ADOLESCENT GIRLS IN
SELECTED HIGHER SECONDARY SCHOOLS,
KOLLAM.
Ms. Aleena L
Ms. Lavanya S Nair
Ms. Shabana Shaji
Ms. Sherin Joseph
MS. Surya Murukan
Department of Obstetrics and Gynecological Nursing
Bishop Benziger College of Nursing, Kollam
Under the guidance of
Mrs. PV Greeshma
Assistant Professor
Department of Obstetrics and Gynecological Nursing
Bishop Benziger College of Nursing, Kollam
ABSTRACT
The research project undertook was “A study to assess the effectiveness of structured teaching
program on knowledge regarding reproductive health among adolescent girls in selected higher secondary
schools, Kollam”. The objectives of the study were to assess the knowledge regarding reproductive health
among adolescent girls and to assess the effectiveness of structured teaching program on knowledge
regarding reproductive health among adolescent girls , Kollam and to find out the association between pre-test
knowledge scores regarding reproductive health among adolescent girls in higher secondary schools and
selected demographic variables ( age, religion, education of father, education of mother, occupation of father,
IJNRDTH00126 International Journal of Novel Research and Development (www.ijnrd.org) 330
© 2024 IJNRD | Volume 9, Issue 4 April 2024| ISSN: 2456-4184 | IJNRD.ORG
occupation of mother, area of residence, type of family, previous knowledge regarding reproductive health ).In
this study samples were 100 adolescent girls of age between 13 and 14 years in selected higher secondary
schools ,Kollam .In order to assess the effectiveness of structured teaching program, the sampling technique
adopted was non probability convenience sampling technique. The tool used for data collection was structured
knowledge questionnaire. The data analysis of the study were based on the objectives of the study using
descriptive and inferential statistics. The findings of the present study revealed that there was significant
difference between pre-test and post-test knowledge scores on knowledge regarding reproductive health
among adolescent girls in selected higher secondary schools, Kollam and there was significant association
between the pretest knowledge scores regarding reproductive health among adolescent girls in selected higher
secondary schools, Kollam with selected demographic variables such as age, religion, education of father,
education of mother, area of residence, type of family, previous knowledge regarding reproductive health.
Based on the findings, the researchers had drawn implications which were vital concerns in the field of
nursing practice, nursing administration, nursing education and also for the future development.
Keywords: Assess, effectiveness, Structured teaching program, Knowledge, Reproductive health, Adolescent
girls.

CHAPTER I
INTRODUCTION
“To acquire knowledge, one must study; but to acquire wisdom, one must observe.”
-Marilyn vos savant
BACKGROUND OF THE STUDY
Reproductive health is the holistic well-being of young people in behavioral, emotional, physical and
social aspects. Reproductive health includes a woman's genitals, menstruation and genital infections. The
reproductive health of young girls is critical to the health of future generations. 1 The National AIDS Control
Organization has included life skills education in school curricula to ensure that young people make informed
decisions about their sexuality and reproductive health. However, there are many obstacles in translating
theory into practice. India's Population Policy 2000 recognized youth as a vulnerable group with special
needs. They constitute almost 20-21% of the population of our country and their number is expected to
increase with time. The reproductive health of adolescent girls is crucial because it determines the health of
future generations. Thus, adolescent girls are at risk of unwanted pregnancy, reproductive tract infections
(RTI), as well as various social and psychological consequences such as dropping out of education, early
marriages, unplanned pregnancies, unsafe abortions and depression. Many teenage girls lack a clear
understanding of ovulation, menstruation, the menstrual cycle, the importance of regular periods, conception,
pregnancy and childbirth. Menstruation can be associated with taboos and myths prevalent in our traditional
society, which have a negative impact on women's health, especially menstrual hygiene. 2
There are more than 355 million menstruating women and girls in India, but millions of girls and
women across the country still face significant barriers to a comfortable and dignified menstrual health
management (MHM) experience. 49,000 young men and 46,000 women are Human immunodeficiency virus
( HIV) positive in India. Young people need to know how to protect themselves from HIV/Sexually
transmited diseases(STI)/RTI and have the resources to access appropriate health services for young people.
About 35% of young men and 19% of young women have comprehensive information about HIV,
emphasizes the need to include age-appropriate adolescent reproductive and sexual health messages,
including HIV/AIDS, in the school curriculum. This framework has been translated into a national adolescent
education program that provides 100% coverage of HIV/AIDS prevention and adolescent reproductive and
sexual health (ARSH) messages in all secondary and post-secondary settings.3
NEED AND SIGNIFICANCE OF THIS STUDY

Adolescence is a time of rapid growth and development. They have little knowledge about
reproductive health (RH). Adolescent girls are more marginalized and face many problems in society.
Through educating every youth about reproductive health. It creates awareness among adolescents. It helps

in preventing reproductive tract infections, including HIV/AIDS. 4 Studies show that adolescent girls lack
adequate information about reproductive health, which makes them face problems such as polycystic ovary
syndrome, early pregnancy, childbirth, abortion, violence, unwanted pregnancies, maternal mortality,
reproductive tract infections and sexually transmitted diseases. When it comes to reproductive health
practices, teenage girls still use cloth as an absorbent during menstruation. Reuse of absorbents is more
common. In one study, it was revealed that 73% of them are using recycled clothes. In India, most schools
lack trash cans and hand soap. The toilets are dirty and the doors are broken and only 42% changed sanitary
pads/clothes at school because litter boxes and soaps are not available. 5
Understanding the problems faced by young people in reproductive health there is need for primary
care physicians to actively participate in reproductive health education of school teachers and frontline health
workers, thus increasing the reach of reproductive education. Globally the prevalence of reproductive tract
infections was 15% of adolescents. Previous studies in South Asia has shown rates of reproductive disorder
ranging from 22-92%. In India, the prevalence of RTI was 9.7%. Currently, the overall prevalence of RTI in
women of childbearing age was 11.75%.6
Reproductive health is important because it affects the individual, their family and their community.
Reproductive health is an essential part of overall health and well being of an individual. Some of the
adolescents tend to be unaware of their own body, their physical well being and psychological changes
happening in their life. Half the adolescents aged 12-15 years don’t know about menstruation until its onset,
changes related to puberty and proper information for handling reproductive tract infection . Hence the
significance of this study.6
STATEMENT OF THE PROBLEM

A study to assess the effectiveness of structured teaching program on knowledge regarding
reproductive health among adolescent girls in selected higher secondary schools, Kollam.
OBJECTIVES
 To assess the knowledge regarding reproductive health among adolescent girls in selected higher
secondary schools, Kollam.
 To assess the effectiveness of structured teaching programme on knowledge regarding reproductive
health among adolescent girls in higher secondary schools, Kollam.
 To find out the association between pretest knowledge scores regarding reproductive health among
adolescent girls in higher secondary schools and selected demographic variables.
OPERATIONAL DEFINITION
 Assess : In this study, Assess refers to determine the knowledge regarding reproductive health among
adolescent girls in higher secondary Schools.

 Effectiveness : In this study, it refers to change in knowledge level of adolescent girls regarding
reproductive health.
 Structured teaching programme: In this study it refers to systemically planned Teaching programme
with teaching aids about reproductive health
 Knowledge: In this study knowledge refers to information regarding reproductive health assessed by
a knowledge questionnaire among adolescent girls in higher secondary school.
 Reproductive health : In this study it refers to a state of complete reproductive health or the total
well-being of behavioural, emotional, physical, and social aspects of adolescence.
 Adolescent girls in higher secondary: In this study it refers to the adolescent girls between age
group of 13-14.
HYPOTHESES
All hypotheses were tested at 0.05 level of significance.
H1: There will be significant difference between pretest and posttest knowledge scores regarding
H2: There will be significant association between the pretest knowledge scores regarding reproductive health
among adolescent girls in selected higher secondary schools, Kollam and selected demographic variables
(age, religion, education of father, education of mother, area of residence, type of family, previous knowledge
regarding reproductive health).

CHAPTER II
REVIEW OF LITERATURE
Review of literature is one of the most important steps in the research process. It is the account of what
is already known about a particular phenomena. It is the description and analysis of literature relavant to
particular field or topic.
This chapter deals with the information collected in relation to the present study
The review of literature is organized as follows:
1. LITERATURE RELATED TO KNOWLEDGE ON REPRODUCTIVE HEALTH AMONG

ADOLESCENT GIRLS
2. LITERATURE RELATED TO EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME

ON REPRODUCTIVE HEALTH AMONG ADOLESCENT GIRLS
3. LITERATURE RELATED TO KNOWLEDGE AND PRACTICE ON MENSTRUAL HYGIENE
4. LITERATURE RELATED TO REPRODUCTIVE TRACT INFECTIONS
1. Literature related to reproductive health
A literature search was conducted using Pubmed,Google scholer and research gate to search for studies
published between 2015 -2021 to investigate knowledge level and effectiveness of structured teaching
programme regarding reproductive health in the world.The results of this study shows that knowledge
regarding reproductive health is increased after intervention.The findings of the study demonstrated that
improper menstrual hygiene practices cause reproductive tract infections and hormonal imbalance,clotting
disorders,uterine fibroids leads to menstrual irregularities.
A cross sectional study was done in Pune to assess knowledge and practices related to menstruation
and reproductive health amongst college going adolescent girls. The data was collected using self-
administered proforma. The study was conducted among 323 adolescent girls admitted in the year 2012 to
professional colleges belonging to the health sciences faculty of a private university in Pune, India. Among
323 adolescent girls, Mean age of onset of menarche was 13.35 years. Many girls (86.65%) had knowledge of
menstruation prior to menarche. For 68% of girls, mother was a source of menstrual information. Half of the
girls reported some form of restriction in activities during menstruation due to religious reasons. 11% girls
suffered from some form of reproductive tract infections (RTIs). Practices related to menstruation revealed
that cloth piece is used for menstrual protection by 3% of girls. Soaked sanitary pads were disposed sanitarily
by 96% of girls. Adolescents of medical faculty had significantly more knowledge than nursing faculty
adolescents regarding emergency contraceptives (P < 0.05). Only four girls reported a history of sexual
contact, of these, three were aware of emergency contraceptives, while one used them to prevent pregnancy. 7

A descriptive cross-sessional study was conducted in Kathmandu valley, Nepal to assess the
knowledge regarding sexual and reproductive health among adolescents. The study was conducted among 200
adolescents in selected higher secondary school. The data was collected by using self administered written
questionnaire. The findings revealed that most of the respondents had knowledge regarding transmission and
protection of HIV/AIDS and STIs but still some respondents had misconception regarding it.The statistical
analysis revealed that the total mean knowledge score with standard deviation was 45.02.67. Nearly half of
the respondents (49.5%) had moderate level of knowledge, followed by inadequate level of knowledge
(29.5%) and adequate level of knowledge( 21.0% )regarding sexual and reproductive health. There was
statistically significant association of level of knowledge with area of residence (p-value 0.002).8
A cross sectional descriptive study was carried out in Dispur,Assam regarding the knowledge and
attitude on reproductive health among high school girls using structured questionnaire including socio
demographic characteristics and 30 items for assessing knowledge and 10 items likert scale to assess attitude
towards reproductive health. The sample was selected by stratified random sampling technique. The study
findings revealed that among 45 subjects, 86.66% girls had moderate level of knowledge and rest 13.44% had
low level of knowledge. 60% had favourable and 40% had neutral attitude towards reproductive
health.Positive association was found between sociodemographic variables with knowledge and attitude.
Knowledge and attitude scores were found to be positively correlated. 9
A descriptive study was executed in Udupi regarding knowledge of adolescents regarding reproductive
health among 100 adolescents in vidyanikedan public school Udupi using structured self- administered
knowledge questionnaire. The sample was selected by purposive sampling technique. Collected data was
analyzed by using descriptive and inferential statistics. The study findings revealed that 66 (66%) adolescents
had poor knowledge level, 28 (28%) adolescents had moderate knowledge, 6 (6%) adolescents had good
knowledge and none of them had excellent knowledge on reproductive health. Area-wise analysis of
knowledge of adolescents regarding reproductive health shows that overall knowledge mean was 15.46 and
means percentage was 40.4 with standard deviation of 2,8 . The variables such as age, educational status,
religion, type of family, and educational status of mother, income of the family, age at menarche and source of
information did not show any significant association with the knowledge. 10
A cross-sectional comparative study was done to explore the knowledge on adolescent reproductive
health among tenth standard student's attending three high schools in Katha Township in Sagaing Region. The
pretested questionnaire was applied. A total of 500 tenth standard students were selected and stratified by
school and gender with stratified random sampling method. The age of studied students were between 14 and
18 years and the mean age was 15.3 (SD=0.7) years. About 60% of them did not know whether a woman can
be pregnant on the first time of sexual intercourse. Over 73% of studied students were aware of any
contraceptive methods. Among them, 66.2% of respondents could mention taking daily pills as a
contraceptive measure, 72% could identify injection and 65.4% could answer condom. HIV/AIDS awareness
among studied students was over 99%. Regarding prevention of HIV transmission among them. 72.9%
answered to use condom. More male students than female students were aware of condom and gender

differences were statistically significant (P<0.05). Only 40% of studied students were aware of sexually
transmitted infections. The male students got higher knowledge score than the female students, and the
difference was statistically significant (P<0.05). 11
A cross-sectional study was conducted among 1,034 secondary school students using a self
administered validated questionnaire. The items with the fewest correct responses included: whether one can
get pregnant after a single act of sexual intercourse (30.4%), whether sexual intercourse causes sexually
transmitted diseases (STDs)(12.4%) and whether washing the vagina after sexual intercourse prevents
pregnancy (17.0%). Their main source of sexual information was friends (64.4%). An independent t-test
revealed the mean knowledge score was significantly higher among females than males. 12
2. Literature related to effectiveness of structured teaching programme on reproductive health among

adolescents girls
A pre-experimental study was conducted in kollam, Kerala to assess Effectiveness of Planned

Teaching Programme on Knowledge Regarding Reproductive Health among Adolescent Girls in Selected
Higher Secondary Schools in Kollam, District. The data was collected using same structured knowledge
questionaire in pretest and post test . In this study the sample size consists of 50 adolescent girls, studying
in school. The selection of sample largely depend upon their availability, for selection of
sample, the purposive sampling technique was used. In the pre test 55 % of the adolescent girls had
average knowledge score and 47 % attained poor knowledge score and no one had good knowledge
score. After post test (99.0 %) of the adolescent girls secured very good knowledge score and the
remained subjects (3 %) secured good knowledge scores.The result showed that the mean post test knowledge
score (X2=35.00) was higher than the mean pre test knowledge score( X1=16.43 ). 13
A pre-experimental study was executed in Haryana to assess effectiveness of Intervention on

Knowledge of Reproductive Health among Adolescent Girls. Tool used contained sections one section
consists of demographic variables and other section consists of Structured knowledge questionnaire of 40
items including menstruation/menstrual hygiene, STI/RTI. HIV/AIDS, anemia. The study was conducted
among 60 adolescent girls in selected school of Rohtak. They were selected by Non-probability convenient
sampling method. The data was analysed using descriptive and inferential statistics. Result revealed pre-test
mean score as 22.08 with SD of 5.69 whereas post-test mean knowledge score was 29.17 with SD of 4.315.
The mean difference between pre-test and post-test score was 7.09. The obtained t-value 12.194 was greater
than tabulated 't-value' at 0.05 level of significance. So intervention was found to be effective. The study
findings show that, there was association between the pre-test knowledge score and education, education of
mother, and source of information regarding menstruation. 14
Interventional study was carried out in Berhampur to assess the effectiveness of planned teaching
program on reproductive health among students of 10th standard The data was collected using self assessment
proforma. The study sample consisted of I44 adolescent girls admitted in the year of 2009-2010 in 10th
standard in Sarojini high school, Ankuli, Berhampur. Most of the adolescent girls were found in age of 15

years no one was in age of 19 years .Students had a good knowledge regarding ovulation, through the
knowledge regarding age at first menses and genital hygiene was poor at pretest. Their knowledge regarding
menstruation and Menstrual hygiene improved after intervention . 15
A quantitative study was done in utter pradesh, India to asses the effectiveness of structured teaching
program regarding Reproductive health on knowledge among adolescent girls in selected school of rural area.
The data was collected using a structured knowledge questionnaire. This study was conducted in 80
adolescent girls and non probability purposive sampling technique was used for the selection of subject and
schools .A structured teaching program was administered to the adolescent group of 13-19 years. The result
revealed that after the intervention, the mean and standard deviation of the post test knowledge was
18.41+3.40 and the mean and standard deviation of pre test knowledge 14.06+2.46.This indicated there was a
significant improvement in the level of knowledge of participants . 16
A pre experimental study was executed in Bhavnagar, Gujarat to assess the effectiveness of
structured teaching Program on Knowledge regarding reproductive health among adolescent girls in selected
schools of Bhavnagar District. The study was conducted among 60 adolescent girls. The data was collected by
using a knowledge questionnaire. The overall pre-test mean knowledge score of adolescent girls was
13.81+3.67, post-test mean knowledge score of was 22.71+2 35. The post test mean knowledge Score was
significantly greater than the pre-test mean knowledge score. So structured teaching programme was
effective.17
A pre experimental study was conducted in Lucknow, Uttar Pradesh to assess the effectiveness of
planned teaching program on knowledge regarding reproductive health among B.Sc. Nursing 1 Year students
of Baba Educational Society, Institute of Paramedical, College of Nursing, Lucknow, Uttar Pradesh. The study
was conducted among thirty 1st year BSC Nursing students in selected colleges. The samples were selected
by non probability convenient sampling technique. In pretest majority (63.33%) of B.SC 1st year student had
average knowledge, whereas in the post-test (46.66%) of student had good knowledge. The mean percentage
of post-test knowledge score was higher (19.33) when compared with mean percentage of pre-test knowledge
score (11.33%) Post-test mean score (1933%) was inferred that the mean difference between pretest and
post-test knowledge score was statistically significant. The computed value was higher than the table value at
0.05 level of significance.18
A Quasi Experimental study was conducted in Barwala regarding Effectiveness of Structured Teaching
Programme on Knowledge and Attitude regarding Reproductive Health among Adolescent Girls in Selected
Senior Secondary Schools, using structured questionnaire. The population were included in the present study
was the adolescent girls (13-19)and Sample size was 50 adolescent girls in selected senior secondary schools,
Barwala. The sample was selected by purposive sampling technique. Descriptive and inferential statistics was
used for data analysis. The study concluded that post test knowledge score on reproductive health was
significantly higher than the mean pre test knowledge score and attitude score among adolescents. 19

An experimental study was executed in utter pradesh to asses the effectiveness of structured teaching
program on knowledge and attitude of adolescent girls regarding Menstrual hygiene management The data
was collected using structured knowledge questionnaire. The study was conducted on 30 adolescent girls
studying in GS Model school, NOIDA.The purposive sampling technique was used for selecting adolescent
girls .It was analysed and interpreted by descriptive statistics based on the objective of study. The mean post
test knowledge score was higher than mean pretest knowledge score and mean post test attitude score was
higher than mean pretest attitude score. The structured teaching program regarding Menstrual hygiene and
management was effective in terms of enhancing the knowledge as well as attitude of adolescent girls.20
3. Literature related to knowledge and practice on menstrual hygiene
A descriptive study was done in Bengaluru to assess the knowledge of adolescent girls regarding
menstruation and menstrual hygiene among PUC students of Dayananda sagar institution. The data was
collected using structured knowledge questionnaire. The study was conducted on 100 adolescent girls selected
by non -random convenient sampling technique. The study revealed that 29 % of the adolescent girls had
moderate knowledge, 70% had adequate knowledge, 1% had inadequate knowledge. This study findings
highlights that there is adequate knowledge about Menstrual hygiene and most of adolescent girls had positive
attitude towards Menstrual hygiene.21
A descriptive cross sectional study was done at Gramin Caledonian college of nursing in Bangladesh
to assess the level of knowledge and practice of menstrual hygiene among female nursing students. A total of
106 female nursing students were selected by purposive sampling technique. Data were collected by self
administered semi structured questionnaire .51.9% of respondents mentioned that menstruation is the uterine
bleeding and 67.0% of respondents were surprised during their first menstruation. About 76.5% of
respondents mentioned that their mode of disposal of absorbents was dustbin and most of them used soap and
water to clean their genital area after menstruation. 22
A cross sectional study conducted at Gedeo zone high school to assess the knowledge and Menstrual
practices among adolescent girls. Data were collected by using interviewer administered questionnaire.791
adolescent girls were selected by random sampling method. The study showed that 68.3% girls had poor
knowledge regarding menstruation. About 48=1% school girls used absorbent materials and 69.5% clean their
genitalia.23
A cross sectional study was carried out in puducherry to asses the menstrual hygiene practices among
adolescent girls .The data was collected using pre designed and pre tested semi structured questionnaire. 528
adolescent girls from 3 villages were included by complete enumeration. Majority of the adolescent girls was
using sanitary pads, fresh and reusable clothes were used by 6.6%and 4.4% respectively.65.3%girls changed
their soaked absorbent 2-5 times in a day. Eventhough, Sanitary pads users were high, unhygienic practices
were noticed, so more emphasize is needed to be given on a awareness of menstrual hygiene practices among
adolescent girls.24

A cross sectional study was executed in Rajasthan to assess practices of menstruation among
adolescent girls, to find out it's related problems and socio-cultural beliefs. 440 adolescent girls were studying
in 9th standard to 12th standard were selected by convenient sampling technique. The data was collected by
using preformed pretested semistructured questionnaire. This study concluded that 68.41% girls had history of
abdominal pain as premenstrual symptom . sanitary napkins were used by 50.22% girls and 66.54% girls were
use water to clean genitalia during menstruation.25
A cross sectional study was conducted at rural and urban high schools in kozhikkode to assess and
compare perception, attitudes and practices of rural and urban high school girls. The data were collected by
questionnaire. The samples were girls studying in 8th and 9th standard and attained menarche. Cluster
sampling methods are used to select the samples. This study revealed that most of the girls gained information
prior to menarche. Girls who wrongly percieved the cause of menstruation was more in rural subjects
compared to urban.50.9% urban girls were not mentally prepared for menarche as compared to 44.4% of rural
girls.83.9% in rural and 78.2% urban had an attitude of menstruation as an unclean phenomena. A higher
proportion of urban girls (55.9%) practiced good menstrual hygiene as compared to average hygiene practiced
by rural girls (48.9%).26
4. Literature related to reproductive tract infections
A descriptive study was conducted in Pune to assess knowledge regarding Vaginal Candidiasis among
adolescent girls in selected urban areas in Pune City. The data was collected using a structured questionnaire.
The sample size was 100. Non probability purposive sampling technique was used to select the sample. In this
study (51%) of the adolescents were having below average followed by average (36%), poor (12%) and good
(11%) knowledge regarding vaginal Candidiasis. The education variable is associated with Level of Education
as the chi-square cale uluted value (22) is more than table value (3.84).27
A Cross sectional Study was carried out in the "Anwesha clinic, The study was carried out on
December 2014 to January 2015 among all the adolescents(10- 19 years) who attended the "Anwesha" clinic
during study period, All adolescent girls attending the clinic were considered for study through, complete
enumeration method. 48% adolescent girls were suffering from RTI. Common age group was 10- 14 years.
70.6% were Muslim and 4.9% were married. RTI was more common among Muslim, and who use no-sanity
napkin during menstruation and belong to lower socio-ecomic class.28
A Quasi-experimental one group pre-post-test design was applied on 100 students at Port-Said
University, Egypt to assess the effectiveness of a training program toward external genital organs' infections
(vulvitis) and it's reported preventive measures among female students. The sample size was 100 students
self-administered Questionnaire schedule was used to collect necessary information. Statistically significant
improvements were found in post-intervention Knowledge of studied students in All tested items regarding
external genital tract infection and its preventive measures (P<0.001). Students with adequate reported
practices to prevent vulvitis rose in all the areas after the program and demonstrated Statistically significant
improvements.29

A quasi experimental study was carried out in Egypt to assess the effectiveness of planned teaching
programme on vaginitis and its preventive measures on adolescent female nursing students knowledge.The
data was collected using structured self administrative questionnaire.One group pretest posttest was the
research design adopted for this study.The sample was 208 students and purposive sampling technique was
used to select samples.The study revealed a statistically significant difference as regards total knowledge
score level between pretest and posttest scores among students,which indicated an improvement in their
knowledge about vaginitis.30
Cross sectional study was done on married women of rural area of Etawah district. Multi stage random
sampling was adopted. The data was collected using structured questionnaire to assess the knowledge,
Attitudes and Practices about RTIs among married women. The study was conducted in 370 married womens
using multi stage random sampling was adopted. A structured questionnaire was used to assess the knowledge,
Attitudes and Practices about RTIs among married women. Chi-square test was used for analysis. The present
study revealed that 42.16 % were aware about RTS. As per their knowledge about symptoms, transmission
and source of infections 35.41 % women told vaginal discharge as commonest symptom of RTIs, 40.0%
women perceived sexual contact with multiple partner as the main route of transmission and 29.46% married
women gained knowledge about RTs from health worker followed by doctors 28 .10%. 31
A cross sectional study was conducted in Paschim midnapur district of West Bengal to find out the
prevalence of reproductive tract infection and health seeking behaviour.The data was collected by house visit
interview.The sample was 2000 currently married women and selected by using stratified multistage random
sampling.The study revealed that the prevalence of reproductive tract infection was 11.7%,which was higher
in 30-35 years age reproductive tract infection is indirectly proportional to literacy status.prevalance of
reproductive tract infection was significantly higher among those who did not use sanitary napkins/clean sun
dried domestic clothes.32

CHAPTER III
RESEARCH METHODOLOGY
Research methodology is a part of the research usually consists of subjects, procedures and data
analysis which gives the details about sampling design, methods of data collection, tool for gathering data and
method of data analysis.33
- B. T Basavanthappa
Research methodology is a design or a plan or a strategy of a research study that gives guidelines,
which directs the research steps, the study process and helps in systematic data collection, logical data
organization and accurate data analysis and accurate data interpretation in a research investigation.
STATEMENT OF THE PROBLEM

A study to assess the effectiveness of structured teaching program on knowledge regarding
OBJECTIVES
1. To assess the knowledge regarding reproductive health among adolescent girls in selected higher
2. To assess the effectiveness of structured teaching program on knowledge regarding reproductive health
among adolescent girls in higher secondary schools, Kollam.
3. To find out the association between pretest knowledge scores regarding reproductive health among
HYPOTHESES
H1: There will be significant difference between pretest and posttest knowledge scores on knowledge
regarding reproductive health among adolescent girls in selected higher secondary schools, Kollam.
H2: There will be significant association between the pretest knowledge scores on knowledge regarding
reproductive health among adolescent girls in selected higher secondary schools, Kollam. with selected
demographic variables (age, religion, education of father, education of mother, area of residence, type of
family, previous knowledge regarding reproductive health)
RESEARCH APPROACH
Research approach is the plan to investigate a phenomenon under study in a structured or unstructured
or a combination of both methods.34

In this study Quantitative research approach was adopted.
RESEARCH DESIGN
Research design is the overall plan for obtaining answer to the research question or for testing research
hypothesis.35
(Polit and Hungler -2007)
The research design adopted for this study is Pre-experimental one group pretest posttest research
design.
The schematic representation of the study is as follows:
DAY 1 DAY 8
O1 X O2
O1 - Pretest
X - Interventions (Structured teaching program)
O2 - Posttest
VARIABLES
Variables are things that measure, manipulate and control in statistics and research . All studies analyse
a variable,which can describe a person,a place, thing or idea.34
Dependent, Independent and Demographic variables were considered in this study.
DEPENDENT VARIABLE
It is the outcome variable which is measured or observed following the action of the independent
variable.34
The dependent variable chosen for this study was knowledge regarding reproductive health among
adolescent girls in selected higher secondary schools, Kollam.
INDEPENDENT VARIABLE
It is the variable that stands alone and doesnot depend on any other.It is the variable that preceeds the
dependent variable.It is also called the cause, stimulus , experiment or treatment. 34
The independent variable chosen for this study was structured teaching program on knowledge
regarding reproductive health among adolescent girls in selected higher secondary schools, Kollam.

DEMOGRAPHIC VARIABLES
A demographic variable is a variable that is collected by researcher to describe the nature and
distribution of the sample used with inferential statistics. 34
In this study the demographic variables were age, religion, education of father, education of mother,
occupation of father, occupation of mother, area of residence, type of family, previous knowledge regarding
Reproductive health.
SETTING OF THE STUDY
Study setting is the location in which the research is conducted.34
The setting for the present study was in Government VHSS ,Thattamala.Kollam.
POPULATION
Population refers to a total category of persons or objects that meets the criteria for study established
by the researcher, any set of persons, objects or measurements having an observable characteristics in
common.36
The population for this study was adolescent girls of age between 13 and 14 years in Government
VHSS, Thattamala, Kollam.
SAMPLE
A Sample is a selected proportion of the defined population. 36
In this study samples were adolescent girls of age between 13 and 14 years in Government VHSS,
Thattamala, Kollam who fulfilled the inclusion criteria.
SAMPLE SIZE
Number of samples are the subjects who will participate in the research study.34
The sample size of this study was 100 adolescent girls in Government VHSS, Thattamala,Kollam.
SAMPLING TECHNIQUE
The sampling technique adopted for this study was convenience sampling technique.
CRITERIA FOR SAMPLE SELECTION
a) INCLUSION CRITERIA
1. Adolescent girls of age group 13 and 14years.
2. Adolescent girls available during the time of data collection.

b) EXCLUSION CRITERIA
1. Adolescent girls who attended previous classes on reproductive health.
2. Adolescent girls not available during the time of data collection.
TOOL AND TECHNIQUE
Data collection or research tool refers to devices or instruments used to collect data.34
Present study was concerned with finding out the effectiveness of structured teaching program on
knowledge regarding reproductive health among adolescent girls in Government VHSS, Thattamala.
Tool consists of:
SECTION A: Demographic proforma.
SECTION B: Structured knowledge Questionnaire.
DEVELOPMENT OR SELECTION OF TOOL
The present study was aimed to assess the effectiveness of structured teaching program regarding
reproductive health among adolescent girls. For the assessment of knowledge, the following steps were
adopted to develop the tool.
STEPS IN THE DEVELOPMENT Of TOOL
Preparation of first draft
Development of criteria check list.
Content validation of tool
Reliability of tool
Preparation of final draft
SECTION A: DEMOGRAPHIC PROFORMA
It consistsed of demographic variables of the adolescent girls such as age, religion, education of father,
education of mother, occupation of father, occupation of mother, area of residence, type of family and
previous knowledge regarding reproductive health.

SECTION B: STRUCTURED KNOWLEDGE QUESTIONNAIRE
It consisted of multiple-choice questions to assess the knowledge of adolescent girls regarding

reproductive health. It included 30 multiple choice questions with four options. Questions covered various
aspects related to reproductive health such as female reproductive system, Menstruation, Reproductive tract
Infections. Maximum score was 30 and minimum score was 0. One correct answer was given a score of ‘one'
and for each wrong response a score of 'zero was given.
Classification of scores:
Category Score
Poor 0 – 14
Adequate 15 – 22
Good 23 – 30
STRUCTURED TEACHING PROGRAMME (STP)
The structured teaching program was based on reproductive health. The topics such as female
reproductive system, Menstruation and Reproductive tract infection were included in structured teaching
program.
CONTENT VALIDITY
Validity is an instrument refers to whether the instrument measures what it is intended to measure. 34
To ensure the content validity, the prepared tool along with the statement of the problem, objectives,
operational definition, hypotheses, structured knowledge questionnaire and lesson plan was given to experts
from the field of nursing, gynecologist, language expert, and school health nurse.
RELIABILITY
Reliability is the degree of consistency or accuracy with which an instrument measures the attributes it
is designed to measure.34
After obtaining permission from Vimalahridaya GHSS, Kollam the tool was administered to
adolescent girls of age between 13 and 14 years on 17.10.2023 . Reliability coefficient was established by
using test-retest method. The Reliability coefficient was calculated by using Karl Pearson’s correlation
formula. The value found out was 0.76 . This indicate that the tool was reliable.
PILOT STUDY
Pilot study was conducted at Vimalahridaya GHSS, Kollam on 17.10.2023 among 10 students who
met the predetermined criteria Informed consent was taken prior to the study from the students and nature of

study was explained. Their knowledge was assessed by using questionnaire. Pretest was done on 17.10.2023.
After conducting the pretest the structured teaching program was given on the same day. On 7 th day, posttest
was conducted on the participants.
ETHICAL CONSIDERATION
Informed consent was obtained from the head of institution, concerned authorities of the institution
and signed assent from the parents of adolescent girls and informed consent was obtained from the
participants. Confidentiality was assured.
DATA COLLECTION PROCESS
Data was collected after obtaining permission from head of the institution and school, Informed
consent was obtained from the parents and signed assent from adolescent girls prior to the study. The purpose
of the study was explained to them. Data collection was done for a period of one week. The convenience
sampling technique was used to select the samples. On the first day of data collection, the structured
knowledge questionnaire was given to adolescent girls who fulfilled the inclusion criteria. Initially the
structured knowledge questionnaire was given to 100 participants and need instructions were provided, after
that teaching program was conducted by the researchers on the same day regarding reproductive health for a
duration of 45 minutes duration. On the 7th day, posttest was conducted by using the same knowledge
questionnaire.
DATA ANALYSIS PROCESS
The researcher’s analyzed the data by using descriptive and inferential statistics based on the
objectives. The data was presented in figures and tables.
1. Demographic data was analyzed using `frequency and percentage’.
2. Knowledge was assessed using `frequency and percentage’. The data was tabulated and analysed in
terms of frequency, percentage, mean and standard deviation.
3. The effectiveness of structured teaching program on knowledge regarding reproductive health was
analyzed by using paired `t’ test.
4. Association between Pretest knowledge scores regarding Reproductive health among adolescents girls
in selected higher secondary schools, Kollam and selected demographic variables was analyzed by
using chi-square test.

CHAPTER IV
ANALYSIS AND INTERPRETATION
Analysis is referred to as a method of organizing data in such a way that research questions can be
answered and all hypotheses were tested.34
This chapter deals with analysis and interpretation of data collected from 100 adolescent girls of
selected schools to assess the effectiveness of structured teaching program on knowledge regarding
reproductive health and the association of knowledge with selected demographic variables.
OBJECTIVES
1. To assess the knowledge regarding reproductive health among adolescent girls in selected higher
HYPOTHESIS
H1: There will be significant difference between pretest and posttest knowledge scores regarding
among adolescent girls in selected higher secondary schools, Kollam with selected demographic
variables (age, religion, education of father, education of mother, area of residence, type of family,
previous knowledge regarding reproductive health)
ORGANIZATION OF THE STUDY FINDING
The researcher analyzed the data by using descriptive and inferential statistics based on the objectives.
The data was presented in figures and tables.
Section A: Demographic data was analyzed using `frequency and percentage’.
Section B:.Knowledge was assessed using ‘frequency and and percentage’. The data was tabulated and
analysed in terms of frequency, percentage, mean and standard deviation.
SectionC: The effectiveness of structured teaching program on knowledge regarding reproductive health was
Section D: Association between Pretest knowledge scores regarding Reproductive health among adolescents
girls in selected higher secondary schools, Kollam and selected demographic variables was analyzed by using
chi-square test.
Section A :Demographic data was analyzed using `frequency and percentage’
This section deals with the frequency and percentage distribution of participant characteristics such as
age, religion, education of father, education of mother, occupation of father, occupation of mother, area of
residence, type of family, previous knowledge regarding reproductive health.
Table : 1 Frequency and percentage distribution of participants according to demographic variables.
Slno Demographic variables Frequency Percentage

1. Age
13 years 47 47%
14 years 53 53%
2. Religion
Hindu 9 9%
Christian 0 0
Muslim 91 91%
3. Education of father
Primary 3 3%
High school 50 50%
Higher secondary 33 33%
Graduation and above 14 14%
4. Education of mother
Primary 6 6%
High school 37 37%
Higher secondary 29 29%
Graduation and above 28 28%
5. Occupation of father
Government 3 3%
Semi-government 4 4%
Private 28 28%
Self/Bussiness 65 65%
6. Occupation of mother
Government 3 3%
Private 9 9%
Self/Bussiness 9 9%

Housewife 79 79%
7. Area of residence
Semirural 46 46%
Rural 21 21%
Semiurban 7 7%
Urban 26 26%
8. Type of family
Nuclear family 65 65%
Joint family 21 21%
Extended family 14 14%
9. Previous knowledge regarding
reproductive health
Yes 96 96%
No 4 4%
If yes, source of information
Newspaper/ Magazine 0 0
Media 0 0
Friends/Relatives 42 43.75%
Health professionals 54 56.25%

(N = 100)
Age
47% 13 yrs
53% 14 yrs
Figure 1: Diagram showing percentage distribution of adolescent girls according to their age.
The data presented in the figure 1 shows that out of 100 participants, 47% were in the age group of 13 years and
53% were in the age group of 14 years.

(N= 100)
100
91%
90
80
70
60
Percentage
50 hindu
40 christian
muslim
30
20
9%
10
0%
0
hindu christian muslim
Religion
Figure 2: Diagram showing percentage distribution of adolescent girls according to their religion.
Figure 2 shows that out of 100 participants, 91% were Muslims and 9% were Hindus.

(N= 100)
60
50%
50
40
33%
Percentage
30 primary
highschool
20 higher secondary
14%
graduation and above
10
3%
0
primary highschool higher secondary graduation and
above
Education of father
Figure 3: Diagram showing percentage distribution of adolescent girls according to the education of father.
Figure shows that 3% had primary level education, 50% had education upto high school level, 29% had higher
secondary level education and 14% were graduates or above.
(N=100)
40
37%
35
30 29%
28%
25
Percentage
20 primary
highschool
15
higher secondary
10 graduation and above

6%
5
0
primary highschool higher secondary graduation and
above
Education of mother
Figure 4: Diagram showing percentage distribution of adolescent girls according to the education of their
mother.

Figure shows that 6% had primary level education, 37% had education upto highschool level, 29% had higher
secondary level education and 28% were graduates or above
(N = 100)
70
65%
60
50
Percentage
40
government
28% semigovernment
30
private
self/bussiness
20
10
3% 4%
0
government semigovernment private self/bussiness
Occupation of father
Figure 5: Diagram showing percentage distribution of adolescent girls according to the occupation of their father.
Figure shows that 3% were government employees, 4% were semi government employees, 28% were private
employees and 65% were having self /business.

(N =100)
79%
80
70
60
50
government
Percentage
40 private
self/bussiness
30
housewife
20
9% 9%
10 3%
0
government private self/bussiness housewife
Occupation of mother
Figure 6: Diagram showing percentage distribution of adolescent girls according to the occupation of their
mother.
Figure 6 shows that 3% were government employees, 9% were private employees, 9% were having self/business
and 76% were housewives.
(N=100)
50
46%
45
40
35
30
Percentage
26% semirural
25
21% rural
20 semiurban
15 urban
10 7%
5
0
semirural rural semiurban urban
Area of residence
Figure 7: Diagram showing percentage distribution of adolescent girls according to their area of residence.

Figure 7 shows that out 100 participants, 46% were living in semi rural area, 21% were in rural area, 7% were
living in semi urban area and 26% were in urban area.
(N=100)
70 65%
60
50
Percentage
40 nuclear family
joint family
30
21% extended family
20 14%
10
0
nuclear family joint family extended family
Type of family
Figure 8: Diagram showing percentage distribution of adolescent girls according to their type of family.
Figure 8 shows that 65% were from nuclear family, 21% were from joint family and 14% were from extended
family.
4%
yes
no
96%
(N=100)
Figure 9: Diagram showing percentage distribution of adolescent girls according to their previous knowledge
regarding reproductive health.

Figure 9 shows that 96% had previous knowledge regarding reproductive health and 4% didn’t have any
knowledge regarding reproductive health.
(N=96)
60 56.25%
50
43.75 %
40
Percentage
newspaer/magazine
30
media
friends/relatives
20
health professionals
10
0% 0%
0
newspaer/magazine media friends/relatives health professionals
Source of information
Figure 10: Diagram showing percentage distribution of adolescent girls according to their source of information.
Figure 10 shows that 43.75% got knowledge from friends/relatives and 56.25% got knowledge from health
professionals.
Frequency and Percentage distribution of knowledge scores among adolescent girls regarding
Table 2: Frequency and Percentage distribution of pretest knowledge scores.
Score Score range Frequency Percentage
0-14 Poor 52 52%
15-22 Adequate 48 48%
23-30 Good 0 0%
Data in Table 2 shows that, 52% participants had poor knowledge, remaining 48% participants had
adequate knowledge and no one had good knowledge.

Table 3: Frequency and percentage distribution of posttest knowledge scores.
Score Score range Frequency Percentage
0-14 Poor 0 0%
15-22 Adequate 29 29%
23-30 Good 71 71%
Data in table 3 shows that, 71% of participants had good knowledge and remaining 29% had adequate
knowledge and no one had poor knowledge.
Section B:. Knowledge was assessed using ‘frequency and and percentage’. The data was tabulated and
analysed in terms of frequency, percentage, mean and standard deviation
Section C: The effectiveness of structured teaching program on knowledge regarding reproductive health was
The knowledge score was assessed using structured knowledge questionnaire. The score range was
categorized as poor (0-14), adequate (15-22) and good (23-30).
Table 4: Mean, standard deviation, t’ value of pretest and posttest knowledge scores of adolescent girls regarding
N Mean SD t
Pretest 100 14.4 2.20
Posttest 100 23.96 10.28 25 .81
t = 1.96, significant at0.05 level.
The data presented in the table 4 shows that the posttest score (23.96) greater than pretest score (14.4) on
knowledge of reproductive health. The t’ value (25.81) is greater than table value (1.96). Hence hypothesis H 1 which
states that There will be significant difference between pretest and posttest knowledge scores on knowledge regarding
reproductive health among adolescent girls in selected higher secondary schools was accepted. It shows that structured
teaching programme was effective in increasing the knowledge of adolescents regarding reproductive health.

Section D: Association between Pretest knowledge scores regarding Reproductive health among adolescents girls
in selected higher secondary schools, Kollam and selected demographic variables was analyzed by using chi-
square test.
Table 5 : Association between knowledge and selected demographic variables.
Knowledge
Variables df Chi square Table Significance
Poor Adequate Good value value
1.Age
13 years 27 19 0 1 2 3.84 NS
14 years 24 30 0
2.Religion
Hindu 4 5 0
Christian 0 0 0 1 0.17 3.84 NS
Muslim 47 44 0
Any other 0 0 0
3.Education of father
Primary 2 1 0
High school 30 21 0 3 6.42 7.82 NS
Higher secondary 16 16 0
Graduation and above 3 11 0
4.Education of mother
Primary 4 2 0
High school 22 16 0 3 9.47 7.82 S
Higher secondary 18 11 0

Graduation and above 7 20 0
5.Occupation of father
Government 1 2 0
Semi-government 2 1 0 3 0.62 7.82 NS
Private 15 13 0
Self/Bussiness 33 33 0
6.Occupation of mother
Government 0 3 0
Private 5 5 0 3 3.55 7.82 NS
Self/Bussiness 5 3 0
Housewife 41 38 0
7.Area of residence
Semirural 25 21 0
Rural 7 13 0
Semiurban 5 2 0 3 3.41 7.82 NS
Urban 14 13 0
8.Type of family
Nuclear family 31 34 0
Joint family 11 11 0 2 1.99 5.99 NS
Extended family 9 4 0

9.Previous knowledge
regarding reproductive
health
Yes 49 48 0 1 0.3 3.84 NS
No 2 1 0
If yes, source of
information
Newspaper/ Magazine 0 0 0
Media 0 0 0 1 1.32 3.84 NS
Friends/Relatives 19 24 0
Health professional 30 24 0
S – Significant
NS – Non significant
The data presented in table 5 shows the association was computed by using chi square test. It was inferred that the
present study shows no association between knowledge regarding reproductive health and demographic variables except
the variable ‘education of mother’. Regarding age, the calculated value 2 is lesser than table value 3.84 at 0.05 level of
significance. Regarding religion, the calculated value 0.17 is lesser than table value 3.84 at 0.05 level of significance.
Regarding education of father, the calculated value 6.42 is lesser than table value 7.82 at 0.05 level of significance.
Regarding education of mother, the calculated value 9.47 is greater than table value 7.82 at 0.05 level of significance.
Regarding occupation of father, the calculated value 0.62 is lesser than 7.82 at 0.05 level of significance. Regarding
occupation of mother, the calculated value 3.55 is lesser than table value 7.82 at 0:05 level of significance. Regarding
area of residence, the calculated value 3.41 is lesser than table value 7.82 at 0.05 level of significance. Regarding type
of family, the calculated value 1.99 is lesser than table value 5.99 at 0.05 level of significance. Regarding previous
knowledge on reproductive health, the calculated value is 0.30 is less than table value 3.84 at 0.05 level of significance
.Regarding source of information, the calculated value 1.32 is lesser than table value 3.84 at 0.05 level of significance.
The result revealed that there was association between knowledge score with demographic variable ‘education of
mother’ only. There was no significant association between knowledge and demographic variables such as age, religion,
education of father, occupation of father, occupation of mother, area of residence, type of family and previous
knowledge regarding reproductive health at 0.05 level of significance. Hence hypothesis H2. There will be significant
association between the pretest knowledge scores on knowledge regarding reproductive health among adolescent girls
in selected higher secondary schools, Kollam with selected demographic variables (age, religion, education of father,
education of mother, area of residence, type of family, previous knowledge regarding reproductive health) was partially
accepted.

CHAPTER V
RESULT
The present study was conducted to assess the effectiveness of structured teaching program on
knowledge regarding reproductive health among adolescent girls in selected higher secondary schools,
Kollam. The data were collected from 100 adolescent girls who met criteria for study. The data were
interrupted on the basis of statistical analysis related to the objectives and need for the study. This chapter
discusses the major feeling of them in terms of results from other studies.
OBJECTIVES
1. To assess the knowledge regarding reproductive health among adolescent girls in selected higher secondary
schools, Kollam.
HYPOTHESES
H1: There will be significant difference between pretest and posttest knowledge scores regarding reproductive
health among adolescent girls in selected higher secondary schools, Kollam.
among adolescent girls in selected higher secondary schools, Kollam with selected demographic
variables (age, religion, education of father, education of mother, area of residence, type of family,
previous knowledge regarding reproductive health).
Major findings of the study sample
Section A: sample characteristics; description of demographic variables under study.
This section deals with the result of the sample characteristics under study It included age, religion ,
education of father, education of mother, occupation of father, occupation of mother, area of residence, type of
family, previous knowledge regarding reproductive health and source of their information. The demographic,
characteristics of the selected samples were analyzed using descriptive statistics including frequency and
percentage distribution.

Demographic data
 Regarding the age of the sample, out of 100 sample, 47% were in the age group of 13 years and 53%
were in the age group of 14 years.
 Regarding the religion of the sample, out of 100 sample, 91% were Muslims and 9% were Hindus.
 Regarding the education of father, 3% had primary level education, 50% had high school level
education, 29% had higher secondary level education and 14% were graduates or above.
 Regarding the education of mother, 6% had primary level education, 37% had high school level
education, 29% had higher secondary level education and 28% were graduates or above.
 Regarding the occupation of father, 3% were government employees, 4% were semi government
employees, 28% were private employees and 65% were having self /business.
 Regarding the occupation of mother, 3% were government employees, 9% were private employees,
9% were having self/business and 76% were housewives.
 Regarding the area of residence, 46% were living in semi rural area, 21% were in rural area ,7% were
living in semi urban area and 26% were in urban area.
 Regarding the type of family, 65% were from nuclear family, 21% were from joint family and 14%
were from extended family.
 Regarding the previous knowledge about reproductive health, 96% had previous knowledge regarding
reproductive health and 4% didn’t have any knowledge regarding reproductive health.
 Regarding the source of information, 43.75% got knowledge from friends/relatives and 56.25% got
knowledge from health professionals.
SECTION B: Evaluation of effectiveness of structured teaching programme on knowledge regarding

reproductive health among adolescent girls.
Comparison of pretest and posttest knowledge score on knowledge regarding reproductive health
among adolescent girls.
Mean, standard deviation, ‘t’ value of pretest and posttest knowledge scores of adolescent girls
regarding reproductive health were computed. The calculated paired ‘t ‘value (25.81) was greater than table
value (1.98) at 0.05 level of significance. Hence the research hypothesis H1 – There will be significant
difference between pretest and posttest knowledge scores on knowledge regarding reproductive health among
adolescent girls in selected higher secondary schools was accepted. This study confirmed that structured
teaching program was effective in increasing the knowledge level of the adolescent girls regarding
SECTION C: Association between Pretest knowledge scores on knowledge regarding reproductive

health among adolescent girls and selected demographic variables.
The association of pretest knowledge score of adolescent girls with selected demographic variables
like age, religion, education of father, education of mother, occupation of father, occupation of mother, area of
residence, type of family, previous knowledge regarding reproductive health and it’s source of information
were computed by chi- square. In this study, there is significant association between knowledge and
demographic variable education of mother ( calculated value is greater than table value at 0.05 level of
significance) and no significant association between knowledge and demographic variables such as age,
religion, education of father, occupation of father, occupation of mother, area of residence, type of family,
previous knowledge regarding reproductive health and it’s source of information ( calculated value is lesser
than table value at 0.05 level of significance).

CHAPTER Vl
DISCUSSION, SUMMARY AND CONCLUSION
This chapter presents the major findings of the study and discusses them in relation to similar studies
conducted by other investigators followed by the summary of the findings Then the implications and
recommendations for professional practice and future research and finally with limitations and a brief
summary.
DISCUSSION
knowledge regarding Reproductive health among adolescent girls in Government Vocational higher secondary
school, Thattamala .In order to achieve the objectives of the study, pre- experimental one group pretest
posttest research design was adopted. The subjects were selected by convenient sampling technique. The
sample consisted of 100 adolescent girls studying in higher secondary school, Kollam. The findings of the
study have been discussed in relation to the objectives and other similar studies.
The objectives of the study:
 To assess the knowledge regarding Reproductive health among adolescent girls in Government
vocational higher secondary school, Thattamala.
 To assess the effectiveness of structured teaching program on knowledge regarding Reproductive
health among adolescent girls.
 To find out the association between pretest knowledge scores regarding rereproductive health
among adolescent girls in higher secondary school and selected demographic variables.
Discussion of findings with other studies based on objectives:
1. To assess the knowledge regarding Reproductive health among adolescent girls:

The present study revealed that 48% of adolescent girls had adequate knowledge, 52% had
poor knowledge and 0% had good knowledge .The above findings are supported by a study which was
conducted to assess the impact of planned teaching program on family life education at high school in
Ankuki, Berhampur. In this study 30.67% adolescent girls had knowledge regarding structural
anatomy and physiology of reproductive organs and 69.33% girls had knowledge regarding
reproductive tract infections.15
2. To assess the effectiveness of structured teaching program on reproductive health among adolescent
girls:
In this present study, pretest shows 48% of adolescent girls had adequate knowledge and 52%
had poor knowledge and 0% had good knowledge. After structured teaching program, The posttest
shows 29% of adolescent girls had adequate knowledge and 71% had good knowledge and 0% had
poor knowledge. The above findings are supported by a study which was conducted at high schools of

Berhampur. In this study, regarding nutrition the average score increased from 39.24% to 88.85%.
Regarding knowledge of high risk behaviour the score increased from 19.44% to 82.87%.The
knowledge on anatomy and physiology of reproductive organs, AIDS and STD , reproductive health
and personal hygiene etc also improved significantly after structured teaching program. 15
3. Association between knowledge regarding Reproductive health among adolescent girls and selected
demographic variables:
The present study showed significant association between knowledge and education of mother
(calculated value is greater than table value at 0.05 significance)and no significant association between
knowledge and demographic variables such as age, religion, education of father, occupation of father,
occupation of mother, area of residence, type of family , previous Knowledge and source of
information. The above findings are supported by a study which was conducted to assess the impact of
planned teaching program on family life education at high school in Ankuki, Berhampur.144
adolescent girls were participated in this study. This study showed significant association between
knowledge and demographic variables such as age, religion, area of residence, education of father and
mother.15
MAJOR FINDINGS
In the present study the demographic data revealed that out of 100 sample , 47% were in the age group
of 13 years and 53% were in the age group of 14 years. Regarding the education of father 3% had primary
level education, 50% of had education up to high school level, 29% had higher secondary level and 14% were
graduates & above. Regarding the education of mother, 6% had primary level , 37% of father’s had education
up to high school level, 29% had higher secondary level and 28% were graduates & above. Regarding the
religion of the sample, out of 100 sample 91% were Muslims and 9% were Hindus. Regarding the occupation
of father, 3% were government employees, 4% were semi government employees , 28% were private
employees and 65% were having self /business. Regarding the occupation of mother, 3% were government
employees, 9% were private employees , 9% were having self/business and 76% were housewife. Regarding
the area of residence, 46% were living in semi rural area , 21% were in rural area ,7% were living in semi
urban area and 26% were in urban area. Regarding the type of family, 65% were from nuclear family, 21%
were from joint family and 14% were from extended family. Also the study revealed that 96% had previous
knowledge regarding reproductive health and 4% didn’t have any knowledge regarding reproductive health.
The main source of information, was from health professionals (56.25%).
Pretest shows that 52% adolescent girls had poor knowledge regarding reproductive health, 48% had
adequate and none of the girls had good knowledge. After intervention study 71% girls had good knowledge
29% had adequate knowledge and none of the girls had poor knowledge regarding reproductive health. So this
revealed that structured teaching program on knowledge regarding reproductive health among adolescent girls
was effective

The association was found by using chi square test. It was inferred that the present study showed
significant association between knowledge and demographic variable ‘education of mother’ ( calculated value
is greater than table value at 0.05 level of significance) and no significant association between knowledge and
demographic variables such as age, religion, education of father, occupation of father, occupation of mother,
area of residence, type of family, previous knowledge regarding reproductive health and it’s source of
information.(calculated values were lesser than table values at 0.05 level of significance).
CONCLUSION
knowledge regarding reproductive health among adolescent girls in selected higher secondary schools,
Kollam. Nursing implication of the study included in the area of nursing practice, nursing education, nursing
administration and nursing research are given below.
NURSING PRACTICE
• The study findings revealed the importance of nurses role in providing information for improving the
knowledge of adolescent girls towards reproductive health.
NURSING EDUCATION
• Teaching the adolescents how to maintain reproductive health, as they need access to accurate
information. They must be informed and empowered to protect themselves from RTI’s.
• Nursing curriculum should provide opportunities for adolescents to know more about reproductive
health.
• Seminars, workshops, conferences should be organized in nursing institutions and educational
institutions to improve their knowledge regarding reproductive health.
NURSING RESEARCH
Research should be directed for exploring and updating the knowledge of nurses regarding
This study can be a baseline for the future studies to build upon and motivate other investigators to
conduct further study.
NURSING ADMINISTRATION
• Nursing administrators must organize service training and continuing education for nurses to get
indepth knowledge regarding reproductive health..
• Nursing administrators should ensure Health education to the public regarding reproductive health.

DELIMITATIONS
The study was conducted with a sample size of 100, so generalization was only possible for the
selected population.
RECOMMENDATIONS
Based on the findings of the study, it is recommended that:
• Similar kind of study can be conducted for a larger group.

• A similar study can be conducted for women belong to the age group between 25-30 years
• A study can be conducted to assess the knowledge regarding reproductive health among housewives.
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27.Dr.Suresh Ray, Komal Khole, Sonupriya Dimble, Siddhi Jagtap, Parshuram Kamble.Knowledge Regarding Vaginal
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28.Sutapa Mandal, Somnath Naskar, Md. Samsuzzaman. Reproductive Tract Infection Among Adolescent Girls
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29.Mervat Gaber Zaghloul, Hadayat Abd El-Raof Amasha. Effectiveness of Training Program on Female’s Students’
Knowledge Regarding Vulvitis and its Preventive Measures: A Quasi-Experimental Study. IOSR Journal of Nursing
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APPENDIX A
INSTITUTIONAL ETHICS CLEARENCE CERTIFICATE

APPENDIX B
LETTER SEEKING PERMISSION TO CONDUCT PILOT STUDY

APPENDIX C
LETTER SEEKING PERMISSION TO CONDUCT MAIN STUDY

APPENDIX D
LETTER SEEKING OPINION AND SUGGESTIONS OF THE EXPERTS FOR
CONTENT VALIDITY AND TOOL
From,
Ms.Aleena.L
Ms.Lavanya S Nair
Ms.Shabana Shaji
Ms.Sherin Joseph
Ms.Surya Murukan
3rd year Bsc Nursing (2020-2024)
Bishop Benziger College of Nursing
Kollam.
To,
………………………………….
Respected Sir/Madam,
Sub: Seeking permission for content validation of the research tool.
We, Ms.Aleena.L ,Ms.Lavanya S Nair, Ms.Shabana Shaji, Ms.Sherin Joseph, Ms.Surya Murukan,3 rd
year Bsc Nursing students of Bishop Benziger College of Nursing would request you to kindly validate our
research tool on “ A study to assess the effectiveness of structured teaching program on knowledge
regarding reproductive health among adolescent girls studying in selected higher secondary schools,
Kollam “.I would be obliged if you kindly affirm your acceptance to undersigned with your valuable
suggestions on this topic .I had attached the details of my study along with the research tool.
Thanking you
Yours sincerely
Date: Ms.Aleena.L
Place: Ms.Lavanya S Nair
Ms.Shabana Shaji
Ms.Sherin Joseph
Ms.Surya Murukan

APPENDIX E
TOOL AND CONTENT VALIDATION CERTIFICATE
This is to certify that I have validated the tool of Ms.Aleena L , Ms.Lavanya S Nair , Ms.Shabana
Shaji , Ms.Sherin Joseph Ms.Surya Murukan, 3rd year Bsc Nursing students who is undertaking the following
study on “A study to assess the effectiveness of structured teaching program on knowledge regarding
reproductive health among adolescent girls studying in selected higher secondary schools, Kollam”.
Place : Signature of the expert:
Date : Designation and address:

APPENDIX F
ACCEPTANCE FORM FOR TOOL VALIDATION AND CONTENT VALIDATION
Name : ………………………………………
Designation : ……………………………………….
Name of institution. : …………………………………………
………………………………………
………………………………………
STATEMENT OF ACCEPTANCE OR NON ACCEPTANCE
I give my acceptance/non acceptance to validate the tool on the topic “ A study to assess the
effectiveness of structured teaching program on knowledge regarding reproductive health among
adolescent girls studying in selected higher secondary schools, Kollam”.
Place : Signature. :
Date: Name. :

APPENDIX G
CRITERIA RATING SCALE FOR EVALUATING AND VALIDATING THE TOOL
Kindly go through the content and place tick mark (✔ ) against questionnaires in the following
column ranging from relevant to not relevant kindly give your opinion in the remark column.
TOOL 1: DEMOGRAPHIC PROFORMA
ITEM NO : RELEVANT NEEDS NOT REMARKS

MODIFICATIONS RELEVANT
1.
2.
3.
4.
5.
6.
7.
8.
9.
Any other suggestions:

TOOL NO 2: STRUCTURED KNOWLEDGE QUESTIONNIRE

ITEM. RELEVANT NEEDS NOT REMARKS
NO MODIFICATION RELEVENT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Any other suggestions:

APPENDIX H
LIST OF EXPERTS WHO VALIDATED THE TOOL
1. Dr. Minupriya S
Consultant Gynecologist and Laparoscopic Surgeon
Bishop Benziger Hospital
Kollam
2. Dr. Annal Angeline
Principal
Kollam
3. Dr. Sindha H Mendez
Academic Professor
Kollam
4. Mrs. Sheeja S
Associate Professor
Department of Community Health Nursing
Kollam
5. Mrs.Jyothilekshmi
Assistant Professor
Kollam

APPENDIX I
INFORMED CONSENT OF PARENT
In signing this document, I________ mother/father of _______hereby accord consent for the research
study conducted by Ms. Surya Murukan, Ms. Sherin Joseph, Ms. Shabana Shaji, Ms. Lavanya S Nair and Ms.
Aleena.L, Bsc Nursing students, Bishop Benziger College of Nursing,Kollam on “A Study to assess the
effectiveness of structured teaching program on knowledge regarding reproductive health among
adolescent girls studying in selected higher secondary schools, Kollam”.
I understand that my child will have to give information for a questionnaire to assess her knowledge
regarding representative health as a part of the study. I have been informed that my willingness for my child to
participate in the study is entirely voluntary. During the course of the study, my child can withdraw from study
.I have been told that my child’s answers to the questions will be kept strictly confidential and will not be
published personally and I have no financial commitments for the study.
I will honor all agreements
Signature of parent:
Signature of investigator:
Place :
Date :

APPENDIX J
INFORMED ASSENT FOR ADOLESCENT GIRLS
I , Kum___________ is agreeing to participate in the research study conducted by Ms. Surya

Murukan, Ms. Sherin Joseph, Ms. Shabana Shaji,Ms. Lavanya S and Ms.Aleena.L,Bsc Nursing students in
Bishop Benziger College of Nursing,Kollam on the topic: “ A Study to assess the effectiveness of structured
teaching program on knowledge regarding reproductive health among adolescent girls studying in selected
higher secondary schools, Kollam” . My participation in this study is voluntary. I know that during the course
of research study I can even withdraw from the study. I do also solemnly declare that my findings of the
research will not be used for any other purpose. Iam happy to add that I have no financial commitments for
the same.
Name of the research participants :
Signature :
Name of the witness :
Signature :
Place :
Date :

APPENDIX K
PARTICIPANT INFORMATION SHEET
Respected Madam/Sir
We,Ms. Surya Murukan, Ms. Sherin Joseph, Ms. Shabana Shaji, Ms. Lavanya S Nair,Ms. Aleena
,Bsc Nursing students,Bishop Benziger College of Nursing, Kollam is conducting a study titled as "A Study
to assess the effectiveness of structured teaching program on knowledge regarding reproductive health
among adolescent girls studying in selected higher secondary schools, Kollam".This study is focused on
knowledge regarding representative health among adolescents girls studying in selected higher secondary
schools , Kollam.
In the study, investigator will approach the students, explain the nature of study, purpose and establish a strong
rapport.At first socio personal and health related data is collected and then a questionnaire will be used to
correct data regarding the knowledge of reproductive health.Afterwards a structured teaching programe will
be conducted by the investigator for "30 minutes" duration. Students will be subjected to the study. Pretest
will be performed to assess the knowledge of the students on the first day and then structured teaching
programe will be given for 30 minutes and post test will be conducted to assess the knowledge regarding
representative health after 7 days using same questionnaire among students.
The participants have voluntarly involved in the study. There is no extra checkup or. complications
due to study.No expenses will be increased on the participation for research purpose.The participants are free
to withdraw from the study at any point of time whenever they need.The information gathered will be kept
strictly confidential and will be used for study purpose only .
Yours faithfully, Name of researcher:

Name of participant: Signature:
Signature : Date:
Date:

APPENDIX L
SECTION A : DEMOGRAPHIC PROFORMA

INSTRUCTIONS
- Following questions are related to your personal information.
- Answer all the questions given below.
- All information will be kept confidential.
- Put tick ( ✔ ) mark in appropriate basis.
1. Age. :
2. Religion
a) Hindu.
b) Christian
c) Muslim
d) Any other
3. Education of Father.
a) Primary
b) High school
c) Higher secondary
d) Graduation & above
4. Education of Mother.
a) Primary
b) High school
c) Higher secondary
d) Graduation & above
5. Occupation of Father.
a) Government
b) Semi government
c) Private
d) Self/Business
6. Occupation of Mother.
a) Government.
b) Private
c) Self/ Bussiness
d) Housewife
7. Area of residence.
a)Semirural
b) Rural

c) Semiurban
d) Urban
8. Type of family
a) Nuclear family
b) Joint family
c) Extended family
9. Previous knowledge regarding reproductive health.
a) Yes. b) No.
If Yes , sources of information
a) Newspaper / Magazine
b) Media
c) Friends / Relatives
d) Health professionals
SECTION B : STRUCTURED KNOWLEDGE QUESTIONNAIRE REGARDING REPRODUCTIVE

HEALTH
INSTRUCTIONS
Following statements are related to reproductive health. Read the following questions carefully, select
the correct answer and put tick mark in the appropriate boxes and each correct answer carries one mark. No
negative mark on wrong answer.
1) According to WHO, Reproductive age refers to
a) 11-45 years
b) 13-48years
c) 15-49 years
d) 18-50 years
2) According to WHO, adolescent age refers to
a) 10-15 Years
b) 10-18 years
c) 10-19 years
d) None of the above

3) Reproductive health refers to
a) Personal
b) Free from infections
c) Personal hygiene and proper caring of reproductive organs
4) According to WHO, reproductive health is the total well being of
a) Behavioural aspects
b) Physical and emotional aspects
c) Social aspects
d) All of the above
5) The key nutrient needed for adolescent girls
a) Calcium
b) Iron
c) Vitamin D
d) All of the above
6) The external reproductive organ
a) Labia majora.
b) uterus.
c) Ovary.
d) Fallopian tube
7) The cell responsible for reproduction in female is
a) Ovum
b) Sperm.
c) Ovary
d) Utreus
8) The organ which produces the ovum is called
a) Urethra
b) Vagina
c) Fallopian tubes
d) Ovaries
9) The Internal reproductive system include
a) Labia majora
b) Labia minora
c) Clitoris
d) Vagina
10) Number of ovaries in female reproductive system
a) 1
b) 2
c) 3
d) 4
11) Uterus lies between
a) Bladder and rectum
b) Cervix and vagina
c) Fallopian tube and ovary
d) Rectum and anus
12) Menstruation usually starts at the age between
a) 8-10 years
b) 11-13 years
c) 14-16 years
d) 17-19 years
13) Menstrual cycle occurs once in every
a) 5 days
b) 28 days.
c) 60 days
d) 90 days.

14) Average day of menstruation
a) 2-3 days
b) 5-7 days
c) 6-8 days
d) 10-15 days
15) Ovulation means
a) Bleeding from uterus.
b) Enlargement of Ovary.
c) Release of egg from ovary.
d) None of the above.
16) Menstrual hygiene means
a) Maintaining hygiene during menstruation
b) Maintaining personal hygiene
c) Maintaining perineal hygiene
d) Maintaining hand hygiene
17) Menstrual cup is made up of
a) Cotton
b) Paper
c) Plastic
d) Rubber.
18) Menstrual cup can be placed upto
a) 2-4 hours.
b) 3-6 hours.
c) 4-8 hours
d) 6-12 hours
19) Advantages of menstrual cup
a) It is affordable
b) It is safer than tampon

c) Eco friendly
d) All of the above
20) Menstrual cup should be emptied in
a) sink.
b) Open place
c) Toilet
21) The painful menstruation means
a) Amenorrhea
b) Dysmenorrhea
c) Endometriosis
d) Oligomenorrhea
22) Sanitary pad should be changed
a) 4-6 hours
b) 6-8 hours
c) 6-12 hours
d) Whenever soaked
23) Disposal of sanitary pad
a) Wrap in paper and throw in routine waste.
b) Burying
c) Flushing
d) Others
24) The used menstruation clothes should be washed
a) under running water
b) With soap and water only
c) With soap and water by adding antiseptic lotion.
d) With hot water

25) The washed menstruation clothes should be dried
a) under sunlight
b) inside the bathroom
c) in the room
d) under warmer
26)Type of undergarments better to wear during menstruation is
a) Cotton
b) Polyester
c) Synthetic
d) Wool
27) The food must be consumed during menstrual days
a)Dates
b) Fruits
c) Vegetables
d)All of the above
28) The most common Reproductive tract infection is
a) Chlamydia
b) Malaria
(c) Urinary tract infections
29) Common signs and symptoms of reproductive tract infection (RTI) is
a) Chest pain
b) Breathing difficulty.
c) Burning and itching sensation while urinating
d) Weakness.

30) Prevention of transmission of reproductive tract infection (RTI) is possible by
a) Use toilet papers while using public washrooms.
b) Proper hygienic practice.
c) Regular bathing
d) All of the above
ANSWER KEY
1) C
2) C
3) C
4) D
5) D
6) A
7) A
8) D
9) D
10) B
11) A
12) B
13) B
14) B
15) C
16) A
17) D
18) D
19) D
20) C
21) B
22) A
23) A
24) C
25) A
26) A
27) D
28) A
29) C
30) D

APPENDIX M
LESSON PLAN

Specific Teaching and learning activities/ AV

Slno: Time objectives Content aids Evaluation
1. 1 min INTRODUCTION
A healthy individual is a person with

overall physical and mental wellbeing.
Reproductive health refers to the
personal hygiene and proper caring of
the reproductive organs.37 Adolescence
is the stage of growth and sexual
maturity. Thus, it is essential to practice
good hygiene habits at this stage itself.
For being healthy, one has to keep
hygiene at a personal level ( personal
hygiene) as well as at the community
level ( social hygiene).38
According to WHO
*Reproductive age refers to 15-49years.
*Adolescent age refers to 10-19years.37
2 1 min Define DEFINITION The teacher defines reproductive health What is
reproductiv by using power point. reproductive
e health. The World Health Organization(WHO) defined reproductive health?
health as, Reproductive health is the total well-being of
behavioural, emotional, physical and social aspects of
adolescence.39


3 4 min Explain the FEMALE REPRODUCTIVE SYSTEM The teacher explains female What is female
female reproductive system by using power reproductive
reproductiv The female reproductive system is made up of internal and point. system?
e system. external sex organs that function in the reproduction of new
offsprings.
Female reproductive system is divided into
a. External reproductive organs
b. Internal reproductive organs40
EXTERNAL REPRODUCTIVE ORGANS

External reproductive organs include mons pubis, labia majora
and minora, clitoris, vaginal opening and perineum. The female
external genital organs are collectively known as vulva.
MONS PUBIS
It is rounded fatty elevation, situated anterior to pubis
symphysis.
LABIA MAJORA
They are two symmetrical folds of skin, which protect the
urethral and vaginal openings, that open into vestibule of
vagina.
LABIA MINORA
They are thin delicate folds of fat-free, hairless skin, which are
located between labia majora.
CLITORIS

It is a small and very sensitive part and it is situated where the

labia minora starts.
VAGINAL OPENING
It is the space between labia minora.
PERINEUM
It is a space between vagina and anal opening.40
INTERNAL REPRODUCTIVE ORGANS

The internal genetalia is the structures within the true pelvis
including vagina ,cervix uterus , fallopian tubes and ovaries.
VAGINA
It is a fibromuscular canal, forming the interior portion of the
female genital tract and birth canal.
Function:
*It allows drainage of menstrual fluids and other secretions.
*Provides a passageway for infants birth.
UTERUS
The uterus is a thick walled, pear- shaped, hollow muscular
organ, situated in pelvic cavity, with the urinary bladder in front
and rectum in behind.
Function:
The uterus plays a significant role in menstruation,
implantation, gestation and labor.

FALLOPIAN TUBES
The uterine tubes are long, tortuous tubes, extending laterally
from the cornua of the uterus. Each tube is 10-12cm long.
Function:
The main function of the fallopian tube is to collect the mature
ovum from ovaries and provide passage to the fertilized ovum
to reach the uterus for implantation.
OVARIES
They are female gonads. They are two in number, situated one
on each side of the uterus in a fossa behind the broad ligament.
Functions:
•ovaries play a critical role in both menstruation and
conception40.
•They produce eggs or ovum for fertilization and they make the
hormones estrogen and progesterone.41
4 2 min Explain MENSTRUATION The teacher explains menstruation and What is
menstruatio Menstruation is the monthly elimination through a bloody normal menstrual cycle by using power menstruation and
n and vaginal discharge of a portion of the lining of the uterus that has point and video clip. normal menstrual
normal been prepared to protect and nurture a fertilized egg in the event cycle?
menstrual of pregnancy.42
cycle.
NORMAL MENSTRUAL CYCLE
The menstrual cycle is the time from the first day of women's
period to the day before next period .The menstruation usually

starts at the age of 10-15 yrs. This period is known as

menarche. The length of menstrual cycle varies from women to
women, but usually occurs once in every 28 days. A typical
cycle lasts between 24 and 38 days. The average day of
menstruation is 5-8 days. Hormonal changes ,stress,
medications cause irregular periods .In an average 28-day
menstrual cycle, ovulation typically occurs about 14 days
before the start of the next menstrual period .Ovulation is the
release of an egg from an ovary. Some people may feel pain in
their lower abdomen at this time and a person’s discharge may
change in colour and consistency. However, each person’s cycle
length may be different, and the time between ovulation and the
start of the next menstrual period may vary.42
5 3 min Enumerate MENSTRUAL HYGIENE The teacher enumerate the tips to What are the tips
the tips to It is a clean menstrual management material to absorb or collect maintain menstrual hygiene by using to maintain
maintain menstrual blood, that can be changed in privacy as often as power point. menstrual
menstrual necessary for the duration of a menstrual period.43 hygiene?
hygiene. - WHO
IMPORTANCE OF MENSTRUAL HYGIENE

Poor menstrual hygiene can pose serious health risks like
reproductive and urinary tract infections .Poor menstrual
hygiene cause infertility and birth complications. Neglecting to
wash hands after changing menstrual products can spread

infections such as hepatitis B and thrush.43
TIPS FOR MAINTAINING MENSTRUAL HYGIENE

Personal hygiene:
 Take daily baths at least twice a day.
 Change under garments when necessary.
 Use only cotton under garments.
 The inner thighs and labial folds should be cleaned
properly in squatting position.
 Never use any kind of deodorants, perfume or talcum
powder directly on the vagina and the surrounding
areas.
Perineal hygiene:
 Perineal area should be washed from front to back to
prevent spread of infection
 After urination, defecation and after changing pads one
should always wash hand properly with soap and water.
Use and disposal of sanitary napkins:
 Use sanitary napkins.
 If not possible ,use clean cloth.
 If using cloth, wash it with antiseptic lotion and dry
them in sunlight.


 The napkins should be changed every 4-6 hours .

 If heavy bleeding is there, the napkins should be
changed every 2-3 hours.
 After using napkin should be wrapped and disposed it in
the bin.43
MENSTRUAL HYGIENE KIT

It includes:
 Menstrual pad / Menstrual cup
 Bath soap /sanitizer
 Multiple pairs of underwear
 A flashlight
 Plastic covers and news paper
 Toilet papers/ tissue paper
 It should be carried during travelling ,functions ,sports
,college and school competitions, especially during
menstrual date.43
6 3 min Explain MENSTRUAL CUP The teacher explains menstrual cup and What are the steps
menstrual steps to use by using power point and for using
cup and Menstrual cup is a small , flexible funnel shaped cup made of video clip. menstrual cup?
steps to rubber or silicon that you insert into your vagina to catch and
use. collect period fluid . We can wear menstrual cup for 6-12 hours


depending on whether or not you have a heavy flow.44

Advantages of using menstrual cup
•It is affordable.
•It is safer than tampons.
•Holds more blood than pads or tampons.
•It is eco-friendly.44
Disadvantages of using menstrual cup
•May be hard to insert or remove.
•May be tough to find the light fit
•May cause an allergic reaction.
•May cause vaginal irritation.44
Steps to insert menstrual cup
1.Wash hands thoroughly.
2.Apply water or water based lubricant to rim of the cup.
3.Tightly fold the menstrual cup in half ,holding it in one hand
with rim facing up.
4. Insert the cup, rim up , into vagina. It should sit a few inches
below the cervix.
5.Once the cup is in vagina , rotate it. It will stops leaks. 44
Steps to remove menstrual cup
1.Wash hands thoroughly.
2.Place index finger and thumb into vagina. Pull the stem of the
cup gently until reach the base.
3.Pinch the base to release the seal and pull down to remove the

cup
4.Once it’s out , empty the cup into the sink or toilet.
After care of menstrual cup
•Reusable menstrual cups should be washed and wiped before
being reinserted into vagina.
•Reusable menstrual cups are durable and can lasts for 6
months to 10 years with proper care.44
6 3 min Explain the PREMENSTRUAL SYNDROME The teacher explains the premenstrual What is
premenstru syndrome by using power point. premenstrual
al Premenstrual syndrome (PMS) has a wide variety of signs and syndrome?
syndrome. symptoms, including mood swings, tender breasts, food
cravings, fatigue, irritability and depression. It’s estimated that
as many as 3 of every 4 menstruating women have experienced
some form of premenstrual syndrome.
Symptoms :
•Tension or anxiety
•Depressed mood
•Crying spells
•Mood swings and irritability or anger
•Appetite changes and food cravings
•Trouble falling asleep (insomnia)
•Social withdrawal
•Poor concentration

•Headache
•Fatigue
•Weight gain related to fluid retention
•Abdominal bloating
•Breast tenderness
•Acne flare-ups
•Constipation or diarrhea45
NORMAL DISCOMFORT DURING MENSTRUATION

• Throbbing or cramping pain in your lower abdomen that
can be intense
• Pain that starts 1 to 3 days before your period, peaks 24
hours after the onset of your period and subsides in 2 to 3 days
• Dull, continuous ache
• Pain that radiates to your lower back and thighs
Some women also have nausea , loose stools , headache ,
dizziness.45


7 4 min Explain the IRREGULAR MENSTRUATION The teacher explains irregular What is irregular
irregular menstruation by using power point . menstruation?
menstruatio Menstrual periods typically last four to seven days and occur
n. roughly every 28 days. Many things cause irregular
menstruation such as changes in hormone levels, stress, certain
health conditions, medications and more.41
Examples of irregular menstruation

•Periods that occur fewer than 21 days or more than 35 days
apart.
•Missing three or more periods in a row.
•Menstrual flow (bleeding) that’s much heavier or lighter than
usual.
•Periods that last longer than seven days.
•Length of time between cycles varies by more than nine days.
For example, one cycle is 28 days, the next is 37 days and the
next is 29 days.
•Periods that are accompanied by severe pain, cramping, nausea
or vomiting.
•Soaking through one or more tampons or sanitary pads in an
hour.
Conditions related to irregular menstruation

 Amenorrhea: A condition where your periods have

stopped completely. The absence of a period for 90 days

or more .
 Oligomenorrhea: A condition where your periods occur
infrequently. You may go more than 35 days between
periods or have six to eight periods a year.
 Dysmenorrhea: A medical term for painful periods and
severe menstrual cramps. Some discomfort during your
cycle is normal.
 Endometriosis: Endometriosis occurs when endometrial
tissue grows outside of your uterus. The tissue often
attaches itself to your ovaries or fallopian tubes.
Endometriosis may cause abnormal bleeding, cramps or
severe pain before and during your period.
 Polycystic ovary syndrome: In polycystic ovary
syndrome (PCOS), your ovaries make large amounts of
androgens, which are a type of hormone. This hormone
prevents or delays ovulation, causing irregular periods.
People with PCOS may stop menstruating completely. 41
8 2 min List down The teacher list down the diet followed What are the diet
the diet DIET SHOULD BE INCLUDE DURING MENSTRUAL during menstrual period by using power followed during
followed PERIOD point. menstrual period?
during
menstrual •Food rich in omega 3 fatty acid. Eg: Salmon ,tuna


period. •Fruits
-Water rich fruits: watermelon , muskmelon , cucumber ,
strawberries
- Sweet fruits : apples , grapes
- Citrus fruits : oranges , lemons, grapes
- Gut friendly fruits : banana
•Vegetables : Green leafy vegetables , tomatoes ,broccoli
•Nuts , beans and lentils
•Drink plenty of water
-2.7 litres / 9-10 glasses
•Yogurt
FOODS TO BE AVOIDED
•Food containing caffeine ,chocolate, tea ,coffee.
•Fatty and fried foods.
•Salty and sour foods containing amount of sodium, Eg:pickle
,canned food, chips etc.
•Diary products. Eg: milk, cheese,butter milk.
•Red meat.


9 4 min Explain REPRODUCTIVE TRACT INFECTION The teacher explains the reproductive What are the
reproductiv tract infections and their preventive preventive
e tract DEFINITION measures by using power point. measures of
infections Reproductive tract infections are infections of the genital tract. reproductive tract
and their They affect both women and men. Some RTIs (such as syphilis infections?
preventive and gonorrhoea) are sexually transmitted, but many are not.
measures. Reproductive tract infections are endogenous infections,
iatrogenic infections and the more commonly known sexually
transmitted infections. Each has its own specific causes and
symptoms, caused by a bacterium, virus, fungus or other
organism.42
Types
According to the WHO guidelines for RTI care for reproductive
health, RTIs can be classified into three categories:
(1)sexually transmitted infections (STIs), which are caused by
organisms acquired during sexual contact;
(2)endogenous infections, which are caused by pathogens
usually present within the reproductive system.chlamydia,
gonorrhoea, syphilis and trichomoniasis, Vaginitis, PID.42
Chlamydia
Common, sexually transmitted infection (STI) that is caused by
the bacteria chlamydia trachomatis. Chlamydia affects people
of all ages but is most common in young women.
Gonorrhoea

Sexually transmitted disease. In women it is characterized by

burning pain while passing urine and purulent discharge from
the cervix and urethra.42
Syphillis
In early stages there may be an ulcer on the genitals which may
be visible if it is on the external genitals, but will not be seen if
it is on the cervix.42
Trichomoniasis
Sexually transmitted infection caused by a parasite.
Trichomoniasis is among the most common sexually
transmitted infections. Risk factors include multiple sexual
partners and having unprotected sex.
Vaginitis
Vaginitis refers to inflammation of vagina. These conditions can
result from a vaginal infection caused by organisms such as
bacteria, yeast or viruses. In some cases vaginitis results from
organisms that are passed between sexual partner.46
Pelvic inflammatory disease

Some of the most serious consequences of RTIs in women
occur when an infection ofthe lower genit al tract (cervix or
vagina) or outside organism reach the upper genital tract
(uterus, fallopian tubes , ovaries and surrounding structures).
Infection ma tissue y become generalized and lifethreatening

and resulting damage and scarring may cause infertility, chronic

pelvic pain and increased risk of ectopic pregnancy.
SIGNS AND SYMPTOMS

The burden of infections is higher in women because it is
mostly asymptomatic or the symptoms are unidentifiable.
However, vaginal discharge is the most typical symptom among
women. The other signs of reproductive system infections in
women are:
• Genital pain.
• Burning and itching sensation while urinating.
• Genital sore
• Lower abdominal pain.
PREVENTION
Raise awareness in the community about STIs/RTIs and how
they can Prevented—especially among populations who may be
at high risk.
Promote early use of clinic services to cure STIs/RTIs
• Always use female hygiene products with well balanced
pH level to avoid skin infection.
• Use soft dry towels to dry off private area.
• Always wipe clean your intimate area from front to back.
• Always prefer cotton breathable innerware to avoid yeast

infection.
• Use unscented pads, scented hygiene products can irritate
the skin
• change your garments daily.
• change your sanitary pads every 4-6 hours. As increased
wetting may causes bacterial infection.
• If using shaving set it must be clean, new, sharp razors and
don’t share it or use it in another area.
• Regular bathing
• Proper hygienic practice during mensuration.
• Use toilet papers while using public washroom.
• Regular hospital checkups.
COMPLICATIONS
•Ectopic pregnancy.
•Infertility.
•Tubo-ovarian abscess.
•Chronic pelvic pain
•Decreased urine output (oliguria)
10 1min SUMMARY
Reproductive health is a state of
complete physical, mental and social
wellbeing and not merely the absence of
disease or infirmity.

Reproductive health is vital in

prevention and control of sexually
transmitted diseases such as AIDS , HIV
etc
11 1 min RECAPITALIZATION
1. What is reproductive health?
2. What is female reproductive system?
3. What is menstruation and normal
menstrual cycle?
4. What are the tips to maintain
menstrual hygiene?
5. What are the steps for using
menstrual cup ?
6. What is premenstrual syndrome?
7. What is irregular menstruation?
8. What are the diet followed during
menstrual period?
9. What are the preventive measures of
reproductive tract infections?


12 1 min . CONCLUSION
At the end of the study , the group of
students got adequate knowledge
regarding reproductive health and they
are able to answer the questions . Now
the students had more knowledge about
female reproductive system ,
menstruation , and reproductive tract
infections.

APPENDIX N
MASTER DATA SHEET
Sample Age Religion Education Education Occupation Occupation Area of Type of Previous Source of Pretest Posttest
of father of mother of father of mother residence family knowledge information compliance compliance
regarding
reproductive
health
1 13 c c d d d a a b - 14 26
2 13 c b c d d a a a c 17 23
3 14 c b b d d b a a c 16 17
4 13 c b c d d a c a c 10 23
5 13 c b b c d a a a d 11 27
6 13 c b b c d a c a c 11 22
of father of mother of father of mother residence family knowledge information Compliance Compliance
regarding
reproductive
health
7 13 c c c d d a b a c 9 28

8 13 c d b c d a a a d 13 25
9 13 c b b d d a a a d 13 24
10 13 c b a d d a a a d 13 19
11 13 c b a d d a a a d 13 22
12 14 c c c d b a b a d 12 21
13 13 c b b d b a c a c 14 27
regarding
reproductive
health
14 13 c b c d d a a a c 14 25
15 13 c c c d d a b b - 14 29
16 13 c c d c d a a b - 17 28
17 13 c b c d d a a a c 16 24
18 14 c d d d c a a a c 15 28

19 13 c d d d d b b a c 15 16
20 14 c b b c d a b a c 17 26
21 13 c c d d d a c a d 13 24
regarding
reproductive
health
22 13 c b b c d b b a d 11 27
23 14 c c a a c b b a c 11 27
24 14 a a b c d d c a c 11 19
25 13 a c d d a a a a d 16 24
26 14 c d d d d b a a c 16 26
27 14 c b b c d b b a c 16 22
28 14 c b d d b d a a c 16 22

regarding
reproductive
health
29 14 a b b c b d a a c 15 18
30 14 a b b c d d a a c 14 26
31 13 c b b d d a c a d 14 27
32 14 c c d c d a a a d 12 26
33 13 a b b c b a b a c 15 24
34 13 c c c c d a a a d 13 22
35 14 c b b d d d b a d 13 27
regarding
reproductive
health
36 14 c d d d c a a a c 15 28
37 13 c b c d c a b a d 12 27

38 13 c c d d d a c a d 15 26
39 13 c b b c d a b a d 12 29
40 14 c c b d d d a a d 15 19
41 14 c c c d d d c a d 16 19
42 14 a d c c b d a a c 14 24
regarding
reproductive
health
43 13 c c d c d a a a d 17 23
44 13 c c c d c b b a c 16 26
45 14 c a b d d d a a c 13 19
46 14 c b d d a d a a c 15 21
47 14 c b b d d d a a d 14 25
48 14 c c c d d d b a d 15 28

49 14 c b b d b d a a c 15 16
regarding
reproductive
health
50 13 c c c b d c b a d 12 24
51 14 c b b d d d a a c 17 21
52 14 c b d b d c a a d 14 27
53 14 a a a c d a a a c 17 20
54 14 c d d a d a b a c 17 26
55 14 c b d d d b a a d 17 28
56 14 c c d b d c b a d 17 23
regarding
reproductive
health

57 14 c c c c d b c a c 11 26
58 14 c b b c d c a a d 11 27
59 14 c c c c d b c a c 17 24
60 14 c c c c c b c a c 13 25
61 14 c b b d d b a a c 13 22
62 14 c b c d d b c a d 18 23
63 13 a c d d a a b a d 16 25
regarding
reproductive
health
64 14 c c c c d d a a d 16 24
65 14 c c c a d d a a d 15 21
66 14 c d d d d d a b - 14 26
67 14 c b b c d d a a d 16 20

68 14 c b d c d d b a d 14 24
69 14 c c d d d c a a d 17 27
70 14 c b b d d c a a c 14 19
regarding
reproductive
health
71 14 c d d d c a a a c 16 28
72 14 c d d d d d a a c 15 25
73 14 c b b d d d a a c 14 23
74 14 c b a d d d b a d 14 25
75 14 c c a d d b a a d 15 21
76 14 c c c c d a a a c 15 20
77 14 c c c d d d a a d 14 23

regarding
reproductive
health
78 14 c c b d c d c a c 13 28
79 14 c b c d d d a a c 13 24
80 14 c b c d d d a a c 14 26
81 13 c c c d d b a a c 12 19
82 13 c b d c d a b a c 18 27
83 13 c c c b d a a a d 13 16
84 13 c c b d d a a a d 10 23
regarding
reproductive
health

85 13 c c b d d a a a d 17 26
86 13 c b b d d a b a d 17 25
87 13 c d b d d b a a d 18 26
88 13 c b c d d a a a d 12 22
89 13 c b c d d a a a d 13 22
90 13 c b c d d a a a d 13 25
91 14 c d b d d b a a d 18 26
regarding
reproductive
health
92 13 c d d d d b a a d 18 26
93 13 c d d c b b a a d 18 28
94 13 c b c d d a a a d 16 25

95 13 c b b d d a a a d 18 29
96 13 a b b c b c a a d 13 23
97 13 c b b d d a a a d 14 25
98 13 c b b d d a a a d 17 24
regarding
reproductive
health
99 14 c b b d c b a a d 9 26
100 13 c c d d d a a a d 14 17

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© 2024 IJNRD | Volume 9, Issue 4 April 2024| ISSN: 2456-4184 | IJNRD.

A STUDY TO ASSESS THE EFFECTIVENESS

Bishop Benziger College of Nursing, Kollam

Under the guidance of

Department of Obstetrics and Gynecological Nursing

Bishop Benziger College of Nursing, Kollam

IJNRDTH00126 International Journal of Novel Research and Development (www.ijnrd.org) 331

NEED AND SIGNIFICANCE OF THIS STUDY

IJNRDTH00126 International Journal of Novel Research and Development (www.ijnrd.org) 332

STATEMENT OF THE PROBLEM

IJNRDTH00126 International Journal of Novel Research and Development (www.ijnrd.org) 333

IJNRDTH00126 International Journal of Novel Research and Development (www.ijnrd.org) 334

The review of literature is organized as follows:

1. LITERATURE RELATED TO KNOWLEDGE ON REPRODUCTIVE HEALTH AMONG

2. LITERATURE RELATED TO EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME

3. LITERATURE RELATED TO KNOWLEDGE AND PRACTICE ON MENSTRUAL HYGIENE

4. LITERATURE RELATED TO REPRODUCTIVE TRACT INFECTIONS

1. Literature related to reproductive health

IJNRDTH00126 International Journal of Novel Research and Development (www.ijnrd.org) 335

IJNRDTH00126 International Journal of Novel Research and Development (www.ijnrd.org) 336

2. Literature related to effectiveness of structured teaching programme on reproductive health among

A pre-experimental study was conducted in kollam, Kerala to assess Effectiveness of Planned

A pre-experimental study was executed in Haryana to assess effectiveness of Intervention on

IJNRDTH00126 International Journal of Novel Research and Development (www.ijnrd.org) 337

IJNRDTH00126 International Journal of Novel Research and Development (www.ijnrd.org) 338

3. Literature related to knowledge and practice on menstrual hygiene

IJNRDTH00126 International Journal of Novel Research and Development (www.ijnrd.org) 339

4. Literature related to reproductive tract infections

IJNRDTH00126 International Journal of Novel Research and Development (www.ijnrd.org) 340

IJNRDTH00126 International Journal of Novel Research and Development (www.ijnrd.org) 341

STATEMENT OF THE PROBLEM

All hypotheses were tested at 0.05 level of significance.

IJNRDTH00126 International Journal of Novel Research and Development (www.ijnrd.org) 342

In this study Quantitative research approach was adopted.

(Polit and Hungler -2007)

The schematic representation of the study is as follows:

X - Interventions (Structured teaching program)

Dependent, Independent and Demographic variables were considered in this study.

IJNRDTH00126 International Journal of Novel Research and Development (www.ijnrd.org) 343

SETTING OF THE STUDY

Study setting is the location in which the research is conducted.34

A Sample is a selected proportion of the defined population. 36

CRITERIA FOR SAMPLE SELECTION

1. Adolescent girls of age group 13 and 14years.

2. Adolescent girls available during the time of data collection.

1. Adolescent girls who attended previous classes on reproductive health.

2. Adolescent girls not available during the time of data collection.

TOOL AND TECHNIQUE

Tool consists of:

SECTION A: Demographic proforma.

SECTION B: Structured knowledge Questionnaire.

DEVELOPMENT OR SELECTION OF TOOL

STEPS IN THE DEVELOPMENT Of TOOL

Preparation of first draft

Development of criteria check list.

Content validation of tool

Preparation of final draft

SECTION A: DEMOGRAPHIC PROFORMA

IJNRDTH00126 International Journal of Novel Research and Development (www.ijnrd.org) 345

SECTION B: STRUCTURED KNOWLEDGE QUESTIONNAIRE