Major correlates and socioeconomic inequalities in hysterectomy among ever-married women in India

This article focuses at the prevalence of hysterectomy, its major correlates, and the socioeconomic inequalities in the prevalence of hysterectomy among women in India. Methods: It used data from 527,865 ever-married women interviewed in 2015-2016 National Family Health Survey-4 from 601,000 households across 640 districts in the country. The economic inequalities in the prevalence of hysterectomy have been analyzed using poor-rich ratio and the concentration index (CI) in addition to the adjusted effects of major correlates through multiple logistic regression. Results: Unadjusted (9.3%) and adjusted prevalence of hysterectomy (odds ratio [OR] =7.3; P < 0.001) are significantly higher among women aged 40 and above. Women from rural areas (OR = 1.2; P < 0.001) and those who were formerly married (6%) were more likely to have undergone hysterectomy. Over two-thirds of hysterectomies were conducted in private health-care facilities, where 51% reported that excessive menstrual bleeding was the main reason for hysterectomy. The value of poor-rich ratio (0.79) and CI (0.121) clearly depicts that hysterectomy is more inclined to be concentrated among middle-to-richer class of women in India. Conclusions: Private health-care sector should have standard regulatory practices to deliver more efficient, accountable, and sustainable maternal health-care services.