Incidence and determinants of hysterectomy in a low-income setting in Gujarat, India

摘要: Hysterectomy is a leading reason for use of health insurance amongst low-income women in India, but there are limited population-level data available to inform policy. This paper reports on the findings mixed-methods study estimate incidence and identify predictors hysterectomy setting Gujarat, India. The estimated hysterectomy, 20.7/1000 woman- years (95% CI: 14.0, 30.8), was considerably higher than reported from other countries, at relatively low mean age 36 years. There strong evidence that among reproductive age, those with lower income least two children underwent rates. Nearly two-thirds undergoing utilized private hospitals, while remainder used government or non-profit facilities. Qualitative research suggested weak sexual services, widespread perception post-reproductive uterus dispensable lack knowledge side effects have resulted normalization hysterectomy. appears be promoted as first second-line treatment menstrual gynaecological disorders actually amenable less invasive procedures. Most sought medical opinions prior both public providers lacked equipment, skills motivation offer alternatives. Profit training benefits also appeared play role some providers' behaviour. Although insecure employment procedure knowing financial physical implications major surgery, future work security afforded by them outweigh risks. Findings suggest sterilization may associated an increased risk potentially through biological attitudinal links. Health policy interventions require improved access services education, along surveillance audits promote high-quality choices life cycle.