Prevalence, socio-demographic determinants, and self-reported reasons for hysterectomy and choice of hospitalization in India

Background: There is limited evidence of hysterectomy in India because of a lack of data in large-scale, nationally representative health surveys. The fifth National Family Health Survey collected direct data on hysterectomy and self-reported reasons for the treatment among women of reproductive age in 2019–21 using the NFHS-5 dataset. This study evaluates the prevalence, determinants, and choice of hospitalization (Public vs. Private) for conducting hysterectomy in India among women aged 15–49 years in 29 states and seven union territories (UTs). Methods Cross-tabulations and percentage distributions were utilized to analyse the prevalence of hysterectomy and the choice of hospitalization (public vs. private) across different socioeconomic backgrounds and reasons for undergoing hysterectomy. A multivariate binary logistic regression model was also used to find statistically significant determinants of hysterectomy. Results In India as a whole, 3% of women aged 15–49 years had undergone a hysterectomy. The percentage of women who had undergone the procedure was found to vary considerably across the states and the UTs. A noticeable fact that emerged was that the majority of the hysterectomies were performed in the private sector in India. Age, place of residence, religion, caste, level of education, geographic region, wealth quintiles, parity, age at first cohabitation of women were found to be the socio-demographic determinants statistically associated with hysterectomy in India. The reasons frequently reported for hysterectomy were excessive menstrual bleeding/pain, followed by fibroids/cysts. Conclusion The percentage and likelihood of undergoing hysterectomy were relatively high among women, those who reside in rural areas, those without schooling, those who belonged to the richest wealth quintile, those with an early age at first cohabitation and those who reside in the eastern and southern parts of India. These findings have policy implications in that reproductive health programme managers should assure regular screening and treatment of issues that lead to hysterectomy.