Singh Shri Kant, Sharma Santosh Kumar, Siddhanta Ankita
Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, Maharashtra, India.
Indian J Community Med. 2020 Jan-Mar;45(1):12-17. doi: 10.4103/ijcm.IJCM_12_19.
This article focuses at the prevalence of hysterectomy, its major correlates, and the socioeconomic inequalities in the prevalence of hysterectomy among women in India.
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.
Unadjusted (9.3%) and adjusted prevalence of hysterectomy (odds ratio [OR] =7.3; < 0.001) are significantly higher among women aged 40 and above. Women from rural areas (OR = 1.2; < 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.
Private health-care sector should have standard regulatory practices to deliver more efficient, accountable, and sustainable maternal health-care services.
本文聚焦于印度女性子宫切除术的患病率、主要相关因素以及子宫切除术患病率中的社会经济不平等现象。
研究使用了2015 - 2016年第四次全国家庭健康调查中来自全国640个地区601,000户家庭的527,865名曾婚女性的访谈数据。除了通过多元逻辑回归分析主要相关因素的调整效应外，还使用贫富比和集中指数（CI）分析了子宫切除术患病率中的经济不平等现象。
40岁及以上女性中，未调整的子宫切除术患病率（9.3%）和调整后的患病率（优势比[OR]=7.3；<0.001）显著更高。农村地区的女性（OR = 1.2；<0.001）以及曾有过婚史的女性（6%）更有可能接受子宫切除术。超过三分之二的子宫切除术在私立医疗机构进行，其中51%报告称月经过多是子宫切除术的主要原因。贫富比（0.79）和集中指数（CI，0.121）的值清楚地表明，子宫切除术更倾向于集中在印度中高收入阶层的女性中。
私立医疗保健部门应制定标准监管措施，以提供更高效、更具问责性和可持续性的孕产妇保健服务。
