Survey Checklist: Factors Affecting Undernourishment Among Students

Dear Participants,
Thank you for taking the time to participate in this important survey aimed at
understanding the factors contributing to undernourishment among students. Your
honest responses will help us identify areas that require attention and develop
effective strategies to address these issues.
Your participation is voluntary, and your responses will remain confidential. If a
question does not apply to your situation, feel free to select the most appropriate
response. Your input is valuable, and we appreciate your cooperation.

Instructions for Respondents:

 Please check the appropriate box (YES or NO) next to each factor to
indicate whether it applies to your experience or perception.
 If a factor is not applicable, check "NO."

NO. FACTORS YES NO

1 Lack of access to nutritious meals at home
2 Limited financial resources for food
3 Busy schedule affecting regular meals
4 Lack of awareness about nutritional needs
5 Limited availability of healthy food options
6 Dietary restrictions or preferences
7 Insufficient knowledge about meal planning
8 High stress levels affecting eating habits
9 Lack of time for proper grocery shopping
10 Limited access to cooking facilities
11 Medical conditions affecting appetite
12 Unhealthy food environment at school
13 Unsafe water/food
14 Cultural factors influencing food choices
15 Lack of peer support for healthy eating
16 Lack of access to nutritious meals at home
17 Limited financial resources for food
18 Inadequate sanitation or insufficient hygiene
19 Lack of awareness about nutritional needs
20 Limited availability of healthy food options

Other comments/ideas/remarks:
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