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Code no.

INSTRUCTIONS :
1. Dear respondents this structured knowledge questionnaire is related to assessing your knowledge and attitude regarding safe motherhood. 2. You are requested to respond all items. 3. Your anonymity will be kept confidential. 4. The data collected will be used only for research purpose. 5. This structured knowledge questionnaire is divided in to 2 sections that is A & B. 6. Section A deals with selected socio demographic variables, section B deal with Safe motherhood . 7. Please tick mark on in front of the appropriate answer as per your opinion.

Section - A Demographic variable 1.Name .. 2.Age in years a) 2o-35 year 3. Gender a)Male b)Female 3.Religion a)Hindu b)Muslim c)Sikh d)Christian 4. Educational status a)illiterate b)Primary education c)Secondary education d)Graduate &above 5.Family income(in rupees ) per month 6.Family types a)Nuclear family

b)Joint family 7.Area of residence a)Rural b) urban

8.Prior knowledge regarding safe mother hood a)Yes b)No If yes, from - family member /relative/friend Media (Newspaper, TV, Radio, etc. ) Aanganwadi worker role play/health talk others 9.Is anyone in your family from health profession a)Yes b)No If yes in which profession Doctor Nurses Paramedical 10. occupation:-

Mother , Father None (house wife, unemployed ) Agriculture Self-Business Job(govt.,pvt.) Section-B Questionnaire:1. Safe motherhood stands for. A. women receive the care to be safe throughout pregnancy and childbirth. B. To prevent abortion only. C. To prevent fetal death only. D. To improve the family health. 2. Safe motherhood can be achieved by. A. Improving the health of the mother. B. Improving the health of father. C. Improving the health of the family member. D. Improve the status of children in the society 3.General health of the pregnant women depends upon . A. Only clean and safe water supply. B. Only Proper personal hygiene. C. Balanced diet and good mental health, personal hygiene.

D. Only Good mental health. 4. First sign of pregnancy is. A. High blood pressure B. Absence of menstrual cycle C. Anemia D. Weight 5. Physiological changes during pregnancy except. A. Breast enlargement. B. Weight gain. C. Increased Abdominal girth D. fever D. loss 5.Minimum antenatal visit during pregnancy. A. 2times B. 4times C. 5times D. 6 times 6.Correct time of first antenatal visit. A. Within first 3 months B. 5 month C. 6 month

D. 9 month 7.Poor nutritional status during pregnancy can result in A. vomiting. B. Reduce capacity to think. C. Abdominal pain. D. Complication during pregnancy and child birth. 8.Among the following which is the rich source of calcium A. Lemon juice B. Tea C. Milk D. Dal 9.A pregnant women should avoid to take. A. Dal and green leafy vegetables B. Lots of spicy food C. Milk D. Juice 10.The diet of pregnant women should include A. Reduce total amount of food per day B. Lots of ghee and oil C. Lots of spicy food D. Balance diet including more green leafy vegetables and fruits.

11. Mother having high blood pressure during pregnancy should take. A. Balanced diet B. Oily diet C. Low salt diet D. High fibrous diet 12. Symptoms indicating that a complication may be arising except. A. Vaginal bleeding B. Absent fetal movement. C. Heart burn(acidity) D. Fever 13.In high blood pressure the women may have the feeling of all except. A. Severe headache. B. Giddiness C. Muscle cramps D. Blurring vision 14. Absent fetal movement is the sign of . A. Baby normal B. Fetal death C. Drug side effect D. Fetal malformation 15. Sign of anemia are all except.

A. Breathlessness and tiredness. B. Pale lips and tongue. C. Loss of appetite D. cough 16.The place for doing safe abortion A. Home B. Anganwadi C. Hospital D. Sub center 17. How many T.T dose are required for pregnant women throughout the pregnancy. A. 3 doses B. 2doses C. 1dose D. 4 dose 18.Among the following which medication is recommended during pregnancy. A. Iron- folic acid B. Paracetamol C. Zinc D. D-Cold tab 19.Iron folic acid tablet should be taken with. A. Milk

B. lemon juice(citrus) C. Tea D. Coffee 20. A pregnant women can do. A. Normal household work. B. Heavy or strenuous work. C. Long hours travelling. D. Cycling. 21.A pregnant mother should wear . A. Tight clothes B. Loose and cotton cloths C. Silk cloths D. Dirty cloths 22. A pregnant women should sleep in. A. Sitting position B. Prone position C. Side lying position D. Supine position 23. After delivery the new born should be kept. A. In air conditioner. B. Under direct heat.

C. Warm with clean clothing. D. Uncovered 24.After delivery the child should get . A. Breast feed B. Cows milk C. Water D. Honey 25.Exclusive breast feeding should be given to the baby till A. 1 month B. 3 month C. 5 month D. 6 month 26.In supplementary feeding mother can give to the child. A. Hard food B. Oily food C. Semi-solid ,soft food D. Only water 27. Postnatal exercises helps in A. Removing stretch marks. B. Prevent abdominal pain. C. Keep the reproductive organ back to normal position.

D. Prevent headache. 28. After the 4-6 weeks of delivery mother should revisit the hospital to. A. Detect the genital tract infection. B. Know about the immunization. C. Discuss about the family planning. D. All of the above. 29.Adequate birth spacing between two children. A. Less than 2 yr. B. 3 yr. C. 1yr. D. None of the above 30.Family planning method help individual or couple in. A. To avoid the unwanted pregnancy. B. To reduce the weight. C. To reduce physical stress. D. To reduce the risk of cervical cancer 31.Permanent family planning method in female. A. Tubectomy B. Mala-D C. Copper-T D. Condom

Attitude scale
SA-Strongly agree

A Agree U- Uncertain DA- disagree SA- strongly disagree S.no. Statement 1. It is not necessary to seek information about pregnancy from father.

SA A

DA SA

3. 4. 5. 6. 7. 8. 9.

I feel balanced diet is essential for the mother. Pregnant women should not take rest during the pregnancy. T.T injection is necessary in pregnancy I feel child birth is a frightening experience. Safe motherhood education removes fear about child birth and pregnancy. It is good that knowing the sex of the baby is illegal. I feel it is the husband responsibility to decide the family planning. Father should become a part of safe mother hood. Safe motherhood is womens right 12. I think institutional delivery is safe then home delivery. I think first breast milk should not be given to the baby. I think family planning methods help in maintaining the adequate gap between the children I think sitting position is correct for breast feeding

1o. 11. 12. 13. 14. 15.