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Hysterectomy in India: Spatial and multilevel analysis.

Angad Singh1, Dipti Govil1

  • 1International Institute for Population Sciences, Mumbai, India.

Women'S Health (London, England)
|June 7, 2021
PubMed
Summary

Hysterectomy prevalence in India varies significantly by region, with rural areas and private hospitals showing higher rates. Key determinants include age, parity, wealth, and insurance, while education and sterilization show inverse associations. Further studies and reproductive health education are recommended.

Keywords:
Indiadeterminantsdistricthysterectomyspatial

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Area of Science:

  • Public Health
  • Demography
  • Medical Geography

Background:

  • Hysterectomy is a significant medical procedure with varying prevalence across populations.
  • Understanding the geographical and socio-economic determinants of hysterectomy is crucial for public health interventions.

Purpose of the Study:

  • To map the prevalence of hysterectomy across Indian districts using National Family Health Survey-IV data.
  • To examine the socio-economic, demographic, and medical factors associated with hysterectomy prevalence in India.

Main Methods:

  • Analysis of unit-level data from women aged 15-49 years.
  • Application of descriptive statistics, multivariate techniques, Moran's Index, and Local Indicators of Spatial Association (LISA).
  • Data analysis performed using STATA 14.2, Geo-Da, and Arc-GIS software.

Main Results:

  • Overall hysterectomy prevalence was 3.2%, with significant regional variations (e.g., Andhra Pradesh 8.9%, Assam 0.9%).
  • Higher prevalence was observed in rural areas compared to urban areas, and the majority of procedures occurred in private hospitals.
  • Spatial analysis revealed significant positive autocorrelation in hysterectomy prevalence among districts.
  • Age, parity, wealth, and insurance were positively associated with hysterectomy, while education and sterilization showed negative associations.

Conclusions:

  • Hysterectomy in India is a complex phenomenon influenced by geographical, socio-economic, demographic, and medical factors.
  • The high prevalence in certain regions necessitates in-depth studies and targeted interventions.
  • Promoting reproductive health education, informed choice, surveillance, medical audits, and judicious use of health insurance is recommended.