Major Correlates and Socioeconomic Inequalities in Hysterectomy among Ever-Married Women in India

PURPOSE: 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.