| No. | Questions and Filters |
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| Q201 | Are your parents separated/divorced? | Yes No N/A (no parents/one dead) | 1 2 3 |
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| Q202 | How are the parenting styles of your parents/guardians? [choose the most dominant style in the home if different styles] | · Disciplinarian/strict · Permissive or liberal · Uninvolved · Authoritative/commanding Others Specify__________________) | 1 2 3 4 96 |
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| Q203 | Has your parent/guardian ever been to prison | Yes No Don’t know | 1 2 96 |
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| Q204 | Do your parents drink alcohol? (more than occasional drinking) | Yes No Don’t know | 1 2 96 |
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| Q205 | Have you ever been physically abused by parents/guardian? | Yes No | 1 2 |
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| Q206 | Have you ever been so hurt by your parent/guardian that you wanted to do something about it? | Yes No | 1 2 |
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| Q207 | Have your parents/guardian/anyone else ever abused you sexually? [Includes inappropriate touches] | Yes No | 1 2 |
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| Q207b | If yes, who was it (relationship)? |
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| Q208 | Has any of your parents/guardian had any mental illness (e.g: Visited mental clinic/Hosp or on medication) | Yes No | 1 2 |
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| Q209 | Have you ever talked about sex with your parents/Guardian? | Yes No | 1 2 |
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| Q210 | How do you feel about how protective your parents/guardians are of you? | Very protective Somehow protective Not protective at all | 1 2 3 |
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| Q211 | Have you ever been pregnant? | Yes No | 1 2 |
àQ214 |
| Q212 | If yes, how many times? |
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| Q213 | If yes, how old were you the first time? |
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| Q214 | Do you have a friend who has ever got pregnant? | Yes No | 1 2 |
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| Q215 | Have you ever been tested for HIV? | Yes No | 1 2 |
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| Q216 | Have you ever used family planning/contraceptives? | Yes No | 1 2 |
àQ218 |
| Q217 | If yes, which method (s)? [Can have multiple answers] | Condom Pills Other_________________________ | 1 2 3 |
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| Q218 | Do you have friends who drink alcohol/smoke/drugs? | Yes No | 1 2 |
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| Q219 | Have you ever taken alcohol? | Yes No | 1 2 |
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| Q220 | Have you ever smoked cigarettes? | Yes No | 1 2 |
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| Q221 | Have you ever attempted to take drugs? | Yes No | 1 2 |
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| Q222 | Are you free to go to clubs/dances? | Yes No | 1 2 |
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| Q223 | Have you ever been so sad that you wanted to end your life? | Yes No | 1 2 |
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| Q224 | Do you feel safe at home? | Yes No | 1 2 |
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| Q225 | What age did you start menstruation? |
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| Q226 | Have you ever missed school because of menstruation? | Yes No | 1 2 |
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| Q227 | What do you use during menstruation? | Pads Cloth Cotton Other(specify)___________________ | 1 2 3 4 |
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| Q228 | Who talked to you about menstruation? | Parent Peers School Other | 1 2 3 4 |
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| Q229 | What age did your breasts start developing? |
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