Knowledge on Infertility among People at Gairigaun, Tokha -9

A Research Proposal Submitted as a Partial Fulfillment

Of the Requirement of Bachelor of Science in Nursing
Purbanchal University

Sumi Parajuli
092-6-2-04881-2020
Kathmandu Model Hospital School of Nursing
Swoyambhu, Kathmandu.
2078

i
 APPROVAL SHEET

The research Proposal entitled “Knowledge on Infertility Among People at Raipur ,

Tanahun District ‘’ is Bona-fides work and is being submitted by Sumi Parajuli for the
approval to Kathmandu Model Hospital School of Nursing, Swoyambhu, Kathmandu as a
requirement of Bachelor of Science in Nursing, Purbanchal University has been examined
and is recommended for acceptance and approval.

Approved by:

Research Guide

…………………….

Madam Narayani
Subedi

Assistant Professor Kathmandu Model

Hospital School of Nursing Swoyambhu,

Kathmandu

Date:

Institutional Chief

……………………

Sanu Tuladhar

Principal

Kathmandu Model Hospital School of Nursing

Swoyambhu, Kathmandu

Date:
 ACKNOWLEDGEMENT

This research study “Knowledge On Infertility Among People At Gairigaun , Tokha

municipality’ is contribution by many individuals which has been undertaken for partial
fulfillment of the requirement for the Bachelor of Science in Nursing Program. This
project has been completed with the great deal of support, guidance and assistance which
I received time to time during the whole research process.

At first, the researcher would like to express sincere gratitude to Purbanchal University,
Kathmandu Model Hospital School of Nursing, Swoyambhu, providing this opportunity
to conduct the research study for a partial fulfillment of Bachelor of Science in nursing
program.

The researcher likes to thank the campus chief Sanu Tuladhar for providing necessary
suggestion, encouragement and arrangement to conduct this study.

The researcher also likes to express deep gratitude to Research Advisor Madam Narayani
Subedi for her continuous support and guidance to enhance my skill in the field of my
project. The researcher likes to thanks the members of Institutional Review Committee
(IRC) for giving permission to conduct this research study.

Similarly, the researcher is grateful to all participants without whom this research would
be impossible to conduct. The researcher would also like to thanks to library staffs of the
Kathmandu Model Hospital School of Nursing, Swoyambhu.

At last, the researcher would like to express warm thanks to all the friends and family for
their continuous encouragement and cooperation of this research study.

Sumi Parajuli
 TABLE OF CONTENT

CONTENTS PAGE NUMBER

TITLE PAGE APPROVAL i

ACKNOWLEDGEMENT ii

ABSTRACT iii

LIST OF TABLES iv

LIST OF FIGURES viii

CHAPTER I viii

INTRODUCTION

1.1 Background 1

1.2 Statement of the problem 3

1.3 Need/ Rational of the study 4

1.4 Significance of the study 5

1.5 Objectives of the study 6

1.6 Hypothesis/ Research question 7

1.7 Study variables 7

1.7.1 Independent Variable 7

1.7.2 Dependent Variable 7

1.8 Conceptual Framework 8

1.9 Operational definition 9

CHAPTER II

LITERATURE REVIEW

2.1 Introduction 10

2.2 Literature review 10

2.3 Summary of literature review 17

CHAPTER III

METHODOLOGY
18
3.1 Research Design
18
3.2 Study area/ setting
19
3.3 Study Population
19
3.4 Sample size

3.5 Sampling technique 20

3.6 Inclusion and Exclusion Criteria 21

3.7 Research Instruments / tools

22

3.8 Validity and Reliability of Instrument/ tools 23

3.9 Data Collection Procedure 24

25
3.10 Ethical Consideration

3.11 Plan for Data Processing and Analysis 26

3.12 Budget Planning 27

28
3.13 Work plan for completing the study

3.14 Plan for Dissemination of the study

 REFRENCES

APPENDICS

APPENDIX A: Work plan

APPENDIX B: Budget Expenditure

APPENDIX C: Written Consent Form

APPENDIX D: Questionnaire

APPENDIX E: Approval Letters

Letters to the authority

Letters from the authority

LIST OF TABLES PAGE NUMBER
 CHAPTER I

INTRODUCTION

1.1 Background of the Study

According to WHO,2020 Infertility is a condition of the both male and female reproductive
system as defined by the failure to achieve a pregnancy after 12 months or more of regular
unprotected sexual intercourse 1 . It is also defined as a failure to conceive within one or more
years of regular unprotected coitus2
The infertility are mainly of two types; primary infertility and secondary infertility were primary
fertility denotes those individual who never had conceived and secondary fertility indicates
previous pregnancy but failure to conceive subsequently. The knowledge on infertility among
people is important as it has affected millions of people of reproductive age worldwide and has
an impact on their families and communities.2
Worldwide, 1.9% of women aged 20-44 years were unable to have birth and 10.5% of women
who had previously give birth were unable to have second baby after 5 years of trying .9
According to National Survey of Family Growth (NSFG) on 2018 in USA, data indicated that
1.5 % of all women who intended to become pregnant are infertile (unable to conceive even after
1 year of trying intercourse) and 6.7% of married women aged 15 to 44 years are infertile.3
Similarly, infertility is becoming a public health issue in Europe, across Europe is increasing by
4
8-9% annually . Singapore has one of the lowest total fertility rate in the world with 1.216 birth
per woman, where 0.58% increased from 2018.5 (Ministry of health of Singapore, 2013).
However, a research performed on Korea, 2017 data showed that the infertility rate in Korea is
estimated to more than 13%, increasing every year and there are an increasing number of patients
seeking clinical evaluation and treatment for infertility.6
India faces a high burden of infertility, with 22 to 33 million couples in the reproductive age
suffering from lifetime infertility. Female factor accounts for 40 to 50% of infertility among
infertile couples, while male factor, which is on the rise in India, accounts for 30-40%. 7 Further,
in Pakistan showed the knowledge among the respondent is limited where 25% correctly
identified when infertility is pathological and only 46% knew about the fertile period in women’s
cycle whereas 53% of respondent were misinformed that use of IUCD and OCP may cause
infertility.8
Nearly, in Nepal, infertility has become a major problem as the prevalence of infertility in the
country has been estimated to be around 6.9-9.3%.9. The research conducted on 2017 showed

1
that the lifestyle factors are common which include the sedentary lifestyle of the individual ,
heavy use of the alcohol , smoking , late marriage , miscarriage, obesity and frequent abortion.10
Therefore due to the lack of knowledge and awareness in people the incidence of the risk factors
has greatly high in proportion in which infertility is also one of the major common problem.
Yet, the treatment of infertility and the field of reproductive medicine is rapidly growing with
success that have resolved infertility problems , with simple fertility awareness methods to more
advanced innovations such as IVF (invitro-fertilization ) Artificial Inssimination , ART
(Assisted Reproductive Technology), IUI (intrauterine insemination ) , GIFT (Gamete
intrafallopian transfer) , ZIFT ( Zygote intrafallopian transfer) over the world . 1. (World Health
Organization, 2020). While assisted reproduction technologies (ART) have been available for
more than three decades with 5 million children born worldwide from ART interventions such as
IVF (invitro- fertilization) these technologies are still largely unavailable, inaccessible and
unaffordable in many parts of the world, particularly in low and middle-income countries. 11
Therefore, the problem infertility has become a major problem among the people in developing
country. Thus , a country with the sociocultural background, beliefs and practices with the lack
of proper knowledge on scientific situations such as infertility, in order to identify the knowledge
and myths regarding to the topic the researcher intended to perform this study to assess the
Knowledge on Infertility Among People.

2
Statement of the Problem

Infertility has become a global issue as are many individuals and couples who are unable to
achieve or maintain the pregnancy despite they have high desire to conceive the baby.
As mentioned by WHO on 2020 “infertility is a disease of the reproductive system” that result in
disability.1. As there are numerous cause of infertility in men and women, apart from anatomical
cause the infertility have serious implications on both psychological well-being and social status
of people of women in developing countries. Hence, the overall burden of infertility is likely
underestimated and has not displayed over the last 20 years.6
Despite, in the context of Nepal, the evolution of several advanced medical tools and diagnostic
procedures in the most of the health centers in the rural areas have inadequate infrastructure and
equipment. As in case of infertility there are few trained health care providers in addition to this
health care facilities are inaccessible , unaffordable and not women – friend. 13. Moreover, its
affordability and accessibility has been almost limited within the people who belongs to high
socio-economic status and cannot be afforded by the people who belong to low and middle
socio-economic status individuals and couples who are residing in poor setting 14. Overall, due to
lack of awareness and proper knowledge among people about its causes and consequences most
of the people believes that ‘’infertility problem is associated only with women and it’s not a
problem of men.’’ 15
Further, according to Mahsid Bokaie, ‘’women are unable to distinguish risky behaviors from
healthy behaviors that may marked directly to infertility’’,16 in which according to the data
analysis the beliefs was categorized into three risk factors that affected sexual behaviors in
infertile woman . Firstly, cultural, religious, or ethnic beliefs. Secondly, believing in the effect of
diet on infertility and lastly, effect of the type of intercourse on getting pregnant. Therefore,
discovering the existing beliefs among the reproductive age of the people helped to determine the
misconception and the need of the educational program regarding on importance on sexual
health for infertile women.
Similarly, according to Shrestha K, the knowledge is a key factor associated with fertility and
self-care .8As the infertile couples experience stress in relationships with family and friends and
they cut off themselves from other as they are uncomfortable to share it and they consider
infertility as a private problem. Due to the lack of knowledge regarding infertility in women ,
couple and individual , awareness programs are necessary to conduct focusing on its causes, risk
factors, assurance and the treatment modalities. 17
Therefore, with various problem stated both male and female are equally responsible for the
cause of infertility. Thus, the problem of infertility has not given attention considering the fact
that it is not life threating condition but it has substantial community health problems such as
depression, anxiety domestic violence and social isolation.

3
1.3 Rationale of the Study
The people with inability to have children affects couples worldwide and causes emotional and
psychosocial distress in both men and women. The World Health Organization (WHO) considers
infertility as a disability and thus access to health care for this condition falls under the
Convention on Rights of Person with Disability. 34 million women, predominantly from
developing countries, have infertility resulting from maternal sepsis and unsafe abortion. In
population <60 years of age, infertility is ranked as 5th highest serious global disability.18In
United States, the overall rate of infertility on married women of age is 15-44 is 6.7% based on
recent National Survey of Family Growth.19

A cross-sectional study conducted in Saudi among 227 couple on the topic of knowledge attitude
and perception found that 60% had poor knowledge about factors affecting infertility study that
revealed the participant believed in common misconception about cause of infertility in which
majority of participants 90% believed in black magic as a cause of infertility followed by
supernatural causes wereas 75% had neutral attitude towards infertility. 22

Therefore, the knowledge about infertility is inadequate in many parts of the world. Research has
highlited that knowledge is the key factor associated with fertility self-care knowing about own
fertility and the initiation of treatment, concluding that education about fertility issues is needed
to prevent fear and unnecessary delay in seeking help when faced with problems conceiving.

4
1.4 Significance of this Study

Community People

This study helps to sensitize the people and may seek to medical services and screening.

Researcher
This study will help researcher to find out the Knowledge on Infertility and obtain a baseline data
of the people and can conduct awareness program on prevention, treatment of infertility.

Future Researcher
The finding of this study will be reference or baseline to other researcher in future to conduct
similar studies in depth.

1.5 Objectives of the Study

1.5.1 General Objective

 To find out the knowledge on infertility among people of reproductive age at Gairigaun,
Tokha municipality.

1.5.2 Specific Objectives

To assess knowledge on causative factor of the infertility

To identify the knowledge on prevention of infertility.
To obtain the knowledge on management of infertility.
To assess the level of knowledge on infertility.

5
1.6 Research Question
What is the level of knowledge on infertility among people of reproductive age at Gairigaun,
Tokha . ?

1.7 Variables
1.7.1 Independent variable
Age
Sex
Religion
Education
Occupation

1.7.2 Dependent Variable

Knowledge on Infertility among Reproductive Age people.

6
1.8 Conceptual Framework
A conceptual framework is an integrated concept that provides structure or organizing and
describing the phenomena of interests.

Sex

Religion
Education

Knowledge on
infertility Occupation

Inadequate knowledge
Adequate knowledge

May no seek health care

Seeks health care services and likelihood of
services and having risk factor.
likelihood of
avoiding risk factor.

Figure 1: Conceptual Framework on knowledge on infertility

7
1.9 Operational Definition

Knowledge
Knowledge refers to the information on infertility (introduction, risk factor/ causes, treatment,
prevention, problem) among reproductive age people. The knowledge level will be categorized
on the basis of:

Level of knowledge
High Level: 65-100 score
Moderate level: 35-65 of score
Low level: Below 35 of score in knowledge23

Community People
Both male and female of reproductive age group (female – 19 to 49, male – 19-55 years)
Gairigaun, Tokha.

CHAPTER II

8
 LITERATURE REVIEW

2.1 Introduction
Infertility is “ a disease of the reproductive system defined by the failure to achieve a clinical
pregnancy after 12 months or more of regular unprotected sexual intercourse . “ 1 it affects
millions of people of reproductive age worldwide and has an impact on their families and
communities. Trouble in conceiving may be due to problems with male or female infertility or a
combination of both. Therefore in some cases the cause is unknown.

2.2 Literature Review

As mentioned by, Sumera A., study in 2011 at Pakistan on Topic ‘’ Knowledge, Perception and
Myths regarding infertility among selected adult population in Pakistan. ‘’ A cross – sectional
study was done among 447 respondent was selected through simple random sampling technique.
Data was collected through interview method. The study indicated that only 25% of the
participants correctly recognized that infertility is diagnosed usually after one to two years of
regular unprotected sex. 40% of the participant correctly identified that both male and female are
equally responsible for infertility. 70% of the participant correctly identified irregularity of
menses, blocked tubes and genital tract infections causes’ infertility. However, 76% of
participant was unaware about the smoking that cause the infertility and more that 50% of
participant thought that previous use of oral contraceptive pill (OCP) and IUCD device , leads to
infertility. 5
Similarly, Samar N.H studied in Saudi Arabia on 2013 regarding ‘’ Knowledge, Attitude and
Practices of infertility among Saudi couples.’’ A cross sectional study was done among 381
respondent was selected through probability sampling technique. Data was collected through
interview and questionnaire method. This studies finding shows that 59% of the participants have
poor level of knowledge towards infertility were as 76% of participant have neutral attitude
towards fertility. Therefore, 58.8%of participant believed that infertility is caused were 71.3% of
participant thought that infertility is caused due to excess use of OCP and IUCD.11
A cross sectional study done by Mohammad K , in 2020 , Karachi region to assess Awareness
Regarding Causes of Infertility Among Out-patients at Tertiary Care Hospital in Karachi,
Pakistan in the total population of 854 respondent were 342 people was married and the sample
was collected through interview method by using convenience sampling technique . The result
shows that 250 respondent did not believed that equal proportions of males and females
contribute to infertility were as 326 falsely believed that the usage of the intra-uterine device
contributes to infertility and 278 respondent incorrectly believed that a male achieving erection is
an indication of fertility.12

9
Furthermore, a qualitative study was conducted by Karin.H, on “Infertility – related knowledge
and information – seeking behavior among people of reproductive age in Iran on 2016 with the
total population of 74 respondent of women and men who intended to have children in the future.
Data was collected through interview method with probability sampling technique. The study
shows that the respondent has low to average level of knowledge about infertility as most of
them overestimated the women’s reproductive lifespan and had limited knowledge about the ‘
fertile window’ of the menstrual cycle. Therefore most of the participant agreed that primary
health care providers such as general practitioners are well placed to provide information
regarding infertility as this study identified the several gaps in knowledge among people of
reproductive age about factors that influence infertility and pregnancy health negatively.13
Likewise, Samar N.H studied in Saudi Arabia on 2013 regarding “Knowledge, Attitude and
Practices of infertility among Saudi couples.” A cross sectional study was done among 381
respondent was selected through probability sampling technique. Data collected through
interview and questionnaire method. This studies finding shows that the 59% of the participants
have poor level of knowledge towards fertility. Therefore, 58.8% of participant believed that
infertility is caused due to black magic and supernatural causes were 71.3% of participant though
that infertility is caused due to excess use of OCP and IUCD.14
Moreover, Robert J. studied in Australia on 2013 on the topic “Knowledge about factors that
influence fertility among Australians of Reproductive age”. A cross – sectional study was
performed among 462 interviewers through purposive sampling technique. Data was collected
through interview with telephone survey. the study findings shows that only one in four correctly
identified that male fertility starts to decline before age of 45 and most of 59% were aware that
female obesity and smoking affect fertility, but fewer recognized that male obesity 30% and
smoking 36% also influence fertility. Almost 40% of responded had inadequate knowledge of
when in the menstrual cycle a woman is most likely to conceive.15

10
Summary of literature Review

Various literature study shows that inadequacy of knowledge about infertility was clearly
demonstrated through studies conducted in different countries, research has shown a significant
association between the risk factors and infertility. Likewise, the knowledge regarding infertility
limited as well, more than the people were misinformed about the use of IUCD and OCP may
lead to the infertility. People were aware about the risk factors such as smoking, obesity may
lead to infertility.
Therefore, it is important in society to have some awareness about infertility. In addition, various
treatment can be performed in order to gain the fertility or continue the pregnancy. Hence, both
male and female should be involved in the decision making, information sharing and awareness
program regarding to infertility.

11
 CHAPTER III

Methodology
Methodology is the systematic theoretical analysis of the methods applied to a field of study.
It comprises the theoretical analysis of the body of methods and principles associated with a
branch of knowledge. it includes study design , study area/ settings, study population , sample
size , sampling technique , exclusion criteria, research instruments/ tools, data collection
procedures , ethical consideration, plan for data processing and Analysis , budget planning and
work plan for completing study.

3.1 Research Design

Research design is the major and inseparable part of research as it provides the overview of the
plan, structure and strategy of investigation conceived so as to obtain answer to research question
and control variance.
Descriptive Study will be used to assess the Knowledge on Infertility among people of
reproductive age at Gairigaun, Tokha municipality.

3.2 Research Area / Setting

The study will be conducted in Gairigaun area, tokha municipality, Kathmandu Valley ward no
-8 located in Bagmati Zone of central Nepal. The area consist of total population of 206 of
people the total population of reproductive age people consist of 82 including male and female.

3.3 Study Population

The study population will be the people of reproductive age from Gairigaun area, ward no-8,
tokha municipality. The total population of the reproductive age people is 82.

12
3.4 Sample Size
The sample size will be 68 among the total population of reproductive age. According to the
Solvin’s formula, the percentage of error is 5% (0.05). Now,
N=N/1+Ne2
= 82/1+82X (0.05)2
= 82/1.205
= 68
Therefore the sample size will be 68 of reproductive age of people.

3.5 Sampling Technique

Purposive Sampling Technique will be used to select the study area and sample.

3.6 Inclusion and Exclusion

Exclusion Criteria
People who are sick at the time of data collection including pregnant women.

3.7 Data collection tools and instruments

Semi-structured interview schedule will be developed to assess the knowledge on infertility
among the people of reproductive age. The questionnaire will be developed in simple
understandable language by researcher itself.
Data collection tool consists of two parts.
Part I: semi structured questionnaires related to Socio – demographic information.
Part II: Knowledge related questionnaires to assess their knowledge. The knowledge score will
be categories according to the following criteria.
Inadequate knowledge 0-35
Moderately knowledge 35-65
Adequate knowledge 65-100

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3.8 Validity and Reliability

3.8.1 Validity:
Content validity of the tool will be maintained by consulting with the research experts, experts in
related field and subject expert matter specialist.

3.8.2 Reliability
Reliability will be maintained by pretesting of the tool in 10 %( 8 no. of people) of the sample
size through interview method at the Jalpachowk, Tokha municipality. The study tool will be
revised and finalized on the basis of result obtained from pretest. The tool will be developed in
simple and understandable language.

3.9 Data collection procedure

Data will be collected using interview method with semi- structured questionnaire from only
single individual of reproductive age of each house until the completion of 2 weeks. After getting
permission from participant, maximum 20 – 30 minutes time will be taken from each respondent.
Therefore data will be collected at the private area of the house and the collected questionnaire
will be handled privately.

14
3.10 Ethical Consideration

Permission
Formal permission and approval sheet will be obtained from research committee of Kathmandu
Model Hospital School of Nursing and written permission from concerned ward office of Tokha
Municipality – 8.

Rights of Respondent

Informed consent
It is done to preserve the right of the subject by obtaining the informed consent.
Before doing research, researcher will take informed consent by everyone respondent with full
information about study. The participant will be assured that their participation in the study is
voluntary and that they can withdraw at any time.

Anonymity and confidentiality

The given answers by every respondent will be used only for study purpose. There will be right
to privacy as the information will be coded and when research will be published, no information
will be included that reveals the respondent’s identification.
No discrimination: Human rights and justice will be maintain during the study of population
without any discrimination of age, ethnicity, and socio-economic condition.
There will be fair selection and no any discrimination to the respondent in the ground of caste,
education, level, sex, political thought etc.

15
Security
The data provided by participant such as private information (attitude, beliefs, behavior, opinion
and records) will be kept strictest in the laptop with password. As there will be right to full
disclosure about the information of the patient.
Therefore, privacy will be maintain by preserving the filled questionnaire locked cupboard until
3 years.

Dignity:
The participant’s human dignity will be respected were there will be fully right to refuse
participation and there will be voluntary decisions of study participations.

3.11 Data processing and Analysis

The collected data will be edit, code and recheck. The collected data will analyze and interpret
by descriptive statistical method like frequency and percentage. The findings will be displayed in
different tables.

3.12 Budget Planning

In this study all budget necessary for research is founded by researcher only. The budget plan
detail will be mention in appendix B.

3.13 Work plan

The research will conducted for the period of 8 weeks thus need of the work plan is very
important. Researcher start this research from Bhaisakh 12th and end with the report presentation
and submission at Ashar 9th. Further information will be provided on appendix A.

16
3.14 Dissemination
The researcher intends to disseminate the findings of the study through submission of written
report to following organization/institution & person. However, it will be disseminated to
Researcher committee, Kathmandu Model Hospital School of Nursing Library, Researcher.

17
REFRENCES

1. World Health Organization . “ Overview of Infertility’’ ;2019

[ cited 2020 sep 18 ] Available from : https://www.who.int/health-
topics/infertility#tab=tab_1.

2. DC. Dutta ; A Textbook of Gynecology : Third edition : 2017 ; Jaypee publication :

New Delhi : India : p , 227 .

3. Pal. S. Prevalance of Infertility and Its treatment Among women .Newyork , Jamaica
2018 ; 43(9):14. Retrived from www.uspharm.com

4. Agrawal .A, Sharma.R, lifestyle factor and reproductive health; A hospital study
based in Nepal , ( cited on 2017, march 23), Retrived from: 17717-Article Text-
61332-1-10-20180123 (1).pdf.

5. Ali.S, Sophie R , Shaikh A, “ Knowledge , attitude and practices on infertily among

Saudi couples’’ at Saudi Arabia , Int. J of General Medicine. 2013 [ cited 2021 may
5] Medical College, Aga Khan University , October 04 , 2011.

6. Gautam M , Risal P ; An Emerging Public Health Issue in Nepal ;2017:Available

from https://www.nepjol.info/index.php/ACCLM/article/view/17717

7. Dattijo L, Andreadis N, Aminu B, Umar N , Black K. Knolwedge of infertility among

infertile women in Bauchi Northern Nigeria, 2016 [ cited 2021 May 5] : 4 (4)
Available from : file:///C:/Users/Dell/Downloads/5065420160308.pdf

8. Adetoro OO, Ebomoyi EW, The Prevalance of Infertility in a rural Nigerian

Community, African Journal of Medicine and Medical Science, [cited on 2011,
March 20 ].

9. Ahmed HM, Khan M, Yasmin F, . Awareness regarding causes of infertility among

out-patients at a tertiary care hospital in Karachi, Pakistan. Cureus. 2020 Apr;12(4).
Available from : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233490/

18
10. Hammarberg K, Zosel R, Comoy C, Fertility-related knowledge and information-
seeking behaviour among people of reproductive age: a qualitative study. Human
Fertility. 2017 Apr 3;20(2):88-95.

11. Dattijo L, Andreadis N, Aminu B, Umar N, Black K. Knowledge of infertility among

infertile women in Bauchi, Northern Nigeria. .[ cited from : 2016] ;20(13):3-2.

12. Ministry of Health and Population , Department of Health Services, national

Reproductive Health Commodity Security Strategy , Kathmandu , Nepal [ cited
2015 , may 15], Available from
http://nepal.unfpg.org/en/publication/national.reproductivehealth .

13. Adhikari.P Gupta R, Research on infertility, childlessness and healthcare seeking in

poor setting in Nepal , [ cited on 2018, January 2 ]. Available from
https://snis.ch/projects/marginalised-lives-infertility-childlessness-and-healthcare-
seekin.

14. Shrestha.R, and Shrestha,K. (2018). Knowledge regarding infertility amomg

reproductive age women in selected VDC in Baglung District. Journal of Chitwan
Medical College [cited from 2018 , oct 8] Available from :
https//doi.org/10.326/jmc.v8i32.23739.

15. , Hauke J, Poniewaz M, . Internet as a source of information about infertility among

infertile patients. Ginekologia polska. 2012 Apr 1;83(4):250-4. Available from :
https://europepmc.org/article/med/22712255

16. National Survey of Family Growth ; Fertility – Related Characteristics of Adults

[ cited on 2017 , april 09] ; Available from
https://www.cdc.gov/nchs/nsfg/index.htm#:

19
 APPENDICIES
APPENDIX A: WORKPLAN
Kathmandu Model Hospital School of Nursing
Swoyambhu, Kathmandu
Year 2078
Months Bhaishak Bhaishak Bhaishak Jestha Jestha Jestha Jestha Asar Asar
Activities
Date 12-17 19-20 24-31 4-7 11-18 19-25 25-1 2-4 6-9
Weeks 1st 2nd 3rd 4th 5th 6th 7th 8th 9th

Literature review

Topic presentation

Proposal and
Instrument
presentation

Proposal and
Instrument
presentation

Data Collection

Data analysis and

Report writing

Report presentation

Report submission

20
 APPENDIX B: BUDGET EXPENDITURE
Kathmandu Model Hospital School of Nursing
Swoyambhu, Kathmandu

BUDGET EXPENDITURE
SN Particular Number Rate Amount
1. Stationary
i. Pen 2 10/pcs Rs20
ii. Copy 2 50/pcs Rs100
iii. Eraser 2 5/pcs Rs10
iv. Pencil 2 10/pcs Rs20
v. Sharpner 1 5/pcs Rs5
vi. Chart 5 10/pcs Rs50
paper 5
vii. Metacards 2 3/pcs Rs15
viii. Marker 2 50/pcs Rs100
ix. Tape 1 40/pcs Rs40

2. Printing 1000 Rs4/page Rs4000

3. photocopy 1000 Rs3/page Rs3000
4. Transportation 2 Rs500/route Rs2000
5. Computer work Rs1000 Rs1000
6. Snacks and lunch Rs1000
7. Binding 4 Rs500 Rs2000

8. Miscellaneous Rs1000
Total Rs13525

21
 APPENDIX C: VERBAL OR WRITTEN CONSENT FORM
Kathmandu Model Hospital School of Nursing
Swoyambhu, Kathmandu
INFORMED CONSENT FORM
Research topic: Knowledge On Infertility Among People at Gairighaun, Tokha Municipality.
Research Objectives:
o To assess the knowledge regarding infertility among people at Gairighaun, Tokha
Municipality.

Introduction of the study

It is an academic study, to be conducted as a fulfillment of requirement for bachelor degree of
nursing curriculum of Purbanchal University. Therefore, it is assured that the collected
information will be used only for educational purposed. Your all given information are kept
confidential. During this study you don’t have to face any problem. If you have, any problem and
difficulty you can give up at any time. This all collection information is kept secure and
confidential. We respect your involvement in our study.
Student Name: Sumi Parajuli
Phone no: 9869296598
Supervisor: Mrs. Narayani subedi
College: Kathmandu Model Hospital School of Nursing

Informed Consent
I am informed all about the research study and its objectives/ purpose through Researcher. I give
all information with trust which is use for only academic purpose and it will be kept confidential,
collected information will not be used other than the study purpose. So, I sign written consent as
approval for this study.
Name of Participants:

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Signature:

APPENDIX D: QUESTIONNAIRE
Kathmandu Model Hospital School of Nursing
Swoyambhu, Kathmandu

Introduction of the study

This is an academic study concluded for fulfillment of curriculum in Bachelor degree of nursing
all given information will be used only for research purpose all information obtained from you
will be kept confidential and remain anonymous. If you face any problem and difficulty during
the process you can give up any time. Collected information are kept secure and confidential
until the final result. Your information will be valuable for me. I appreciate your involvement in
our study.

Sumi Parajuli
BSN 4th year
Kathmandu Model Hospital School of Nursing

Instruction: Give your best response as appropriate to question without hesitation. Your honest
answer will be requested. Questions are divided into two parts.

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 PART I

Questions related to Socio-demographic Information

Please give your response as appropriate. Answer without hesitation as the answers will be
anonymous and confidential.
Direction: please read the following question correctly and tick ( ) in correct answer
Code: ………..

1. Age in years ………….

2. Sex :
a. Female b. Male

3. Marital status

a. Married b. Unmarried

4. Religion
a. Hindu c. Buddhist

b. Muslim d. Christian
e. If any other please specify…………………..

6. Types of family

a. Single c. Extended

b. Joint

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7. Education Status

a. illiterate d. can read and write

b. basic level e. secondary education

c. Higher education

8. Occupation

a. Unemployed d. Business

b. Service e. Farming/agriculture
.
c. Homemaker f. Labour

g. If other, mention……….

9. Duration of marriage ( in years)

a. Less than 1 year c. Less than 3 year

b. Less than 2 year d. Less than 5 year

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 PART II

Questionnaire related to knowledge on infertility.

Direction: Please give your response on the question using tick mark ( ) in the given box of
corresponding statement that reflects your degree of agreement with that statement.
Code no: ………….
Age in years: ……….
1. What do you mean by infertility?

a. Unable to bear child even after 1 year of unprotected regular intercourse.

b. unable to bear a child after using contraception

c. Unable to conceive baby with irregular menstrual cycle

d. Unable to bear a child even after 2 years of irregular intercourse.

2. What are the major risk factors of infertility? (Multiple response).

a. Excess use of oral contraceptive pills and IUCD

b. Smoking

c. Obesity

d. Underweight

e. Sedentary lifestyle

f. Irregular menstrual cycle

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 g. Abnormal sperm production / function

h. Sexually transmitted Disease

i. Thyroid dysfunction

j. Tobacco use

k. Alcohol consumption

l. Genetics

3. What are the causes of male infertility? ( Multiple Response)

a. Failure to deposit sperm in vagina.

b. Erectile dysfunction

c. Impotence

d. Ejaculatory failure

e. Low sperm count or quality

f. Prostate cancer

4. What are the causes of female infertility? ( Multiple Response )

a. Hormonal imbalance

b. Abnormal mensuration cycle

c. Structural damage in reproductive organ

d. Problem with egg number and quality

e. Early menopause

f. Uterine cancer

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 g. Blocked tubes

h. Infection of genital tract

i. Psychological stress

5. In what age range there is a marked decrease in a woman’s ability to become pregnant?

a. 25-29

b. 29-35

c. 35-39

d. 40-49

6. How can infertility be prevented? ( Multiple Response )

a. Quitting Smoking

b. Maintaining by healthy diet

c. Maintaining healthy weight

d. Taking nutrition and balance diet

e. Maintaining healthy sexual behavior

f. Reducing alcohol consumption

g. Regularly visiting health care provider

h. Awareness program on infertility

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7. Who need to seek for treatment, if there is problem of infertility?

a. Both husband and wife should go to hospital for checkup.

b. Only wife should go to hospital for checkup.

c. Only husband should go to hospital for checkup.

d. Nobody should go anywhere.

8. What are the investigation of infertility?

a. Semen analysis

b. Blood test to identify hormonal level

c. Imaging such as USG

d. Testicular biopsy

9. What are the medical therapy of infertility?

a. Surgery to reopen the tube

b. Antibiotic to treat STIs

c. Hormone replacement therapy

d. Dietary supplement and vitamins

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 e. Medicine to treat ejaculation , erectile problem

f. Counseling

10. What are the management modalities for infertility? ( multiple response )

a. Invitro – fertilization (test tube baby)

b. Artificial inseminination in men

c. Adoption of child

d. Egg and sperm donation

e. Intracytoplasmic sperm injection (ICSI)

f. Don’t know

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