PMID- 38336664
OWN - NLM
STAT- MEDLINE
DCOM- 20240214
LR  - 20240214
IS  - 1472-6874 (Electronic)
IS  - 1472-6874 (Linking)
VI  - 24
IP  - 1
DP  - 2024 Feb 9
TI  - Key drivers of hysterectomy among women of reproductive age in three states in 
      India: comparative evidence from NFHS-4 and NFHS-5.
PG  - 107
LID - 10.1186/s12905-024-02886-7 [doi]
LID - 107
AB  - PURPOSE: According to the 4th and 5th rounds of National Family Health Survey 
      (NFHS), there is high prevalence of hysterectomies in the three states of Andhra 
      Pradesh Telangana and Bihar. The three said states have more than double the 
      number of hysterectomies taking place than the national average. Our purpose is 
      to analyse whether these rates are increasing, decreasing or have stabilized and 
      their reasons thereof. Such an analyses will help the policy makers in 
      recommending good clinical practices within their states. MATERIAL AND METHODS: 
      We used data from NFHS-4 (2015-16) and NFHS-5 (2019-2021) rounds. We calculated 
      the differences in predicted probabilities for various factors, performed a 
      Fairlie Decomposition analyses to quantify the positive and negative contributors 
      in the prevalence of hysterectomy across the three states over two time points, 
      and assessed the association of various socio-demographic characteristics to 
      hysterectomy through a multilevel logistic regression model. RESULTS AND 
      CONCLUSION: The results show that out of a total of 80,976 eligible respondents 
      from the states under study, 5826 respondents self-reported that they had a 
      hysterectomy done. It was found that older age, living in rural areas, belonging 
      to other backward classes and higher wealth quintile, and higher parity 
      positively contributed to the increased prevalence of hysterectomies in the three 
      states. Higher educational attainment and previous use of family planning methods 
      acted as protective factors. Characteristics at the household level had the 
      highest intra-class correlation value in the prevalence of hysterectomy among 
      women, followed by the Primary Sampling Unit and District levels, indicating high 
      clustering in the prevalence of hysterectomy at the household level in all three 
      states. Heavy menstrual bleeding/pain was the leading cause of hysterectomies in 
      all three states, followed by fibroids/cysts in Andhra Pradesh and Telangana and 
      Uterine disorder/ prolapse in Bihar. Over 80% of hysterectomies took place in the 
      private hospitals. RECOMMENDATIONS: The study recommends better, more efficient 
      and accountable hysterectomy surveillance to ensure more sustainable woman's 
      reproductive health services in India. Government should adopt and implement 
      standard regulatory guidelines to prevent provider-driven avoidable 
      hysterectomies. Moreover, we recommend informing primary care professionals about 
      the long-term health effects of hysterectomy and promoting alternate therapies 
      for treating uterine fibroids and heavy bleeding.
CI  - (c) 2024. The Author(s).
FAU - Singh, Shri Kant
AU  - Singh SK
AUID- ORCID: 0000-0003-0824-9073
AD  - Department of Survey Research and Data Analytics, International Institute for 
      Population Sciences, Mumbai, Maharashtra, India.
FAU - Chauhan, Kirti
AU  - Chauhan K
AUID- ORCID: 0000-0002-6208-9229
AD  - Department of Survey Research and Data Analytics, International Institute for 
      Population Sciences, Mumbai, Maharashtra, India. kirti070197@gmail.com.
AD  - Department of Biostatistics and Demography, International Institute for 
      Population Sciences, Mumbai, Maharashtra, India. kirti070197@gmail.com.
FAU - Tripathi, Vrijesh
AU  - Tripathi V
AUID- ORCID: 0000-0003-4212-2658
AD  - Department of Mathematics and Statistics, The University of the West Indies, St. 
      Augustine, Trinidad and Tobago.
LA  - eng
PT  - Journal Article
DEP - 20240209
PL  - England
TA  - BMC Womens Health
JT  - BMC women's health
JID - 101088690
SB  - IM
MH  - Female
MH  - Humans
MH  - Hysterectomy
MH  - *Uterine Diseases
MH  - Reproduction
MH  - Family Characteristics
MH  - *Leiomyoma
MH  - *Uterine Prolapse
MH  - India/epidemiology
PMC - PMC10854047
OTO - NOTNLM
OT  - Andhra Pradesh
OT  - Bihar
OT  - Decomposition
OT  - Hysterectomy
OT  - Multilevel analysis
OT  - Telangana
COIS- The authors declare no competing interests.
EDAT- 2024/02/10 13:18
MHDA- 2024/02/11 07:19
PMCR- 2024/02/09
CRDT- 2024/02/09 23:34
PHST- 2023/06/14 00:00 [received]
PHST- 2024/01/04 00:00 [accepted]
PHST- 2024/02/11 07:19 [medline]
PHST- 2024/02/10 13:18 [pubmed]
PHST- 2024/02/09 23:34 [entrez]
PHST- 2024/02/09 00:00 [pmc-release]
AID - 10.1186/s12905-024-02886-7 [pii]
AID - 2886 [pii]
AID - 10.1186/s12905-024-02886-7 [doi]
PST - epublish
SO  - BMC Womens Health. 2024 Feb 9;24(1):107. doi: 10.1186/s12905-024-02886-7.