Faculty of Public Health - Andalas University - OCS, 13th IEA SEA Meeting and ICPH - SDev

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Unpacking the young age at hysterectomy in India: First time national estimates of prevalence, risk factors and variation across states
Sapna Desai, Ankita Shukla

Last modified: 2018-08-07

Abstract


Background

The young age at hysterectomy in India has been the subject of health policy debates for several years. In the absence of national-level data, community-based studies indicate that hysterectomy is most commonly performed amongst low-income women and as a treatment for common gynecological disorders.

Materials and methods

The National Family Health Survey-4 in 2015-16 collected information on hysterectomy for the first time. The analysis utilizes multivariate logistic regression to examine predictors of hysterectomy nationally and for four high prevalence states, Andhra Pradesh, Telangana, Gujarat and Bihar.

 

Results

The prevalence of hysterectomy in India amongst all women (15-49) was 3.2% and 9.2% amongst those in ages 40-49, at a median age of 34 years.  Excessive menstrual bleeding and pain was the leading reported cause. Two-thirds of women reported undergoing hysterectomy in private facilities. Odds of hysterectomy were higher amongst rural, less educated and Hindu women, and amongst women with higher income levels. Patterns varied considerably across states, including the direction of the relationship with sterilization status.

 

Conclusions

Health policy in India must address the young age at hysterectomy; state-level variation; and non-invasive treatment for menstrual disorders.  Equitable access to first-line gynecological care and guidelines for appropriate use of hysterectomy are required.