Spatial and Multilevel Analysis of Hysterectomy: A Study of India and Its States

Angad Singh , International Institute for Population Sciences (IIPS)
Dipti Govil, International Institute for Population Sciences (IIPS)

Unit level data from NFHS-IV (2015-16) has been used to examine the spatial distribution and socio-economic and demographic determinants of hysterectomy in India. Multilevel logistic regression, Local Moran’s Index and LISA techniques have been used. The prevalence of hysterectomy was 3.2% in India; highest in south Indian states especially in Andhra Pradesh (8.9%) and lowest in Assam (0.9%). The mean age at hysterectomy was 34 years. Moran’s-I (0.58) indicates the positive auto-correlation for prevalence of hysterectomy among districts; total 207 districts had significant neighbourhood association. Variation in prevalence of hysterectomy was attributed to the factors at PSU, District, and State level. Parity, age at sterilisation, low age at first cohabitation, wealth, insurance and empowerment were positively associated with the prevalence of hysterectomy. Majority women underwent the operation in Private hospitals. The primary reason was excessive menstrual bleeding. Unnecessary hysterectomy at younger ages may deteriorate the quality of life of women.

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 Presented in Session 11. Health & Mortality 2