{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T23:08:08Z","timestamp":1780700888867,"version":"3.54.1"},"reference-count":41,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Using the unit-level data of women aged 15\u201349 years from National Family Health Survey-IV (2015\u20132016), the article maps the prevalence of hysterectomy across districts in India and examines its determinants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Descriptive statistics, multivariate techniques, Moran\u2019s Index and Local indicators of Spatial Association were used to understand the objectives. The data were analysed in STATA 14.2, Geo-Da and Arc-GIS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In India, the prevalence of hysterectomy operation was 3.2%, the highest in Andhra Pradesh (8.9%) and the lowest in Assam (0.9%). Rural India had higher a prevalence than urban India. The majority of women underwent the operation in private hospitals. Hysterectomy prevalence ranged between 3% and 5% in 126 districts, 5% and 7% in 47 districts and more than 7% in 26 districts. Moran\u2019s Index (0.58) indicated the positive autocorrelation for the prevalence of hysterectomy among districts; a total of 202 districts had significant neighbourhood association. Variation in the prevalence of hysterectomy was attributed to the factors at the primary sampling unit, district and state level. Age, parity, wealth and insurance were positively associated with the prevalence of hysterectomy, whereas education and sterilization was negatively associated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Hysterectomy operation in India presented the geographical, socio-economic, demographic and medical phenomenon. The high prevalence of hysterectomy in many parts of the country suggested conducting in-depth studies, considering the life cycle approach and providing counselling and education to women about their reproductive rights and informed choice. Surveillance and medical audits and promoting the judicial use of health insurance can be of great help.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455065211017068","type":"journal-article","created":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T02:51:46Z","timestamp":1623034306000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Hysterectomy in India: Spatial and multilevel analysis"],"prefix":"10.1177","volume":"17","author":[{"given":"Angad","family":"Singh","sequence":"first","affiliation":[{"name":"International Institute for Population Sciences, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0599-0045","authenticated-orcid":false,"given":"Dipti","family":"Govil","sequence":"additional","affiliation":[{"name":"International Institute for Population Sciences, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,6,6]]},"reference":[{"key":"bibr1-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.02.019"},{"key":"bibr2-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2009.12.016"},{"key":"bibr3-17455065211017068","unstructured":"Gor HB. Hysterectomy: background, history of the procedure, problem, https:\/\/emedicine.medscape.com\/article\/267273-overview (2018, accessed 13 August 2019)."},{"issue":"30","key":"bibr4-17455065211017068","first-page":"508","volume":"108","author":"Stang A","year":"2011","journal-title":"Dtsch Arztebl Int"},{"key":"bibr5-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1016\/j.curobgyn.2006.04.004"},{"key":"bibr6-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-199712000-00029"},{"issue":"1","key":"bibr7-17455065211017068","first-page":"1","volume":"19","author":"Uzun R","year":"2009","journal-title":"Turkiye Klinikleri J Gynecol Obstetric"},{"key":"bibr8-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1097\/SPV.0b013e3181cb9931"},{"issue":"3","key":"bibr9-17455065211017068","first-page":"700","volume":"31","author":"Goktas SB","year":"2015","journal-title":"Pak J Med Sci"},{"key":"bibr10-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(74)92074-1"},{"key":"bibr11-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1017\/S0021932000000377"},{"key":"bibr12-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.02.018"},{"key":"bibr13-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000010421"},{"key":"bibr14-17455065211017068","first-page":"e2780","volume":"24","author":"Silva Cde M","year":"2016","journal-title":"Revista Latino-americana De Enfermagem"},{"key":"bibr15-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czw099"},{"issue":"1","key":"bibr16-17455065211017068","first-page":"21","volume":"51","author":"Brummitt K","year":"2006","journal-title":"J Reprod Med"},{"key":"bibr17-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1136\/jech.56.6.461"},{"key":"bibr18-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2009.12.017"},{"key":"bibr19-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2008.09.025"},{"key":"bibr20-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-019-0780-z"},{"key":"bibr21-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-017-0445-8"},{"key":"bibr22-17455065211017068","unstructured":"Kameswari S, Vinjamuri P. Medical ethics in the Health Sector: a case study of hysterectomy in Andhra Pradesh. Hyderabad: National Institute of Nutrition. Life HRG. https:\/\/signalsinthefog.files.wordpress.com\/2015\/02\/hysterectomy-ethics-in-s-t-for-setdev-final-1.pdf. (2010, accessed 10 October 2019)."},{"key":"bibr23-17455065211017068","unstructured":"Prayas. Understanding the reason for rising number of hysterectomies in India: national consultation. Jaipur: Prayas, http:\/\/www.prayaschittor.org\/pdf\/Hysterectomy-report.pdf. (2013, accessed 25 October 2019)."},{"issue":"2","key":"bibr24-17455065211017068","first-page":"579","volume":"8","author":"Sardeshpande N","year":"2014","journal-title":"Int J Innov Appl Stud"},{"key":"bibr25-17455065211017068","unstructured":"Jadhav R. Why many women in Maharashtra\u2019s Beed district have no wombs. The Hindu Business Line, 8 April 2019. https:\/\/www.thehindubusinessline.com\/economy\/agri-business\/why-half-the-women-inmaharashtras-beed-district-have-no-wombs\/article26773974.ece. (2019, accessed 13 October 2019)."},{"key":"bibr26-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2015.12.046"},{"key":"bibr27-17455065211017068","unstructured":"McGivering J. The Indian women pushed into hysterectomies. The British Broadcasting Corporation, https:\/\/www.bbc.com\/news\/magazine-21297606 (2013, accessed 5 September 2016)."},{"key":"bibr28-17455065211017068","unstructured":"Dar A. Demand to include hysterectomies in National Family Health Survey. The Hindu, August 19, https:\/\/www.thehindu.com\/todays-paper\/tpnational\/demand-to-include-hysterectomies-in-national-family-healthsurvey\/article5036626.ece (2013, accessed 13 October 2019)."},{"key":"bibr29-17455065211017068","unstructured":"Kameswari S, Vinjamuri P. Case study on unindicated hysterectomies in Andhra Pradesh. Life-Health Reinforcement group. National Consultation on Understanding the Reasons for Rising Hysterectomies in India. 12 August, http:\/\/www.prayaschittor.org\/pdf\/Hysterectomy-report.pdf (2013, accessed 22 February 2021)."},{"key":"bibr30-17455065211017068","unstructured":"Singh S. 16,000 \u2018illegal\u2019 hysterectomies done in Bihar for insurance benefit. Indian Express, 27 August, https:\/\/indianexpress.com\/article\/news-archive\/web\/16-000-illegal-hysterectomies-done-in-bihar-for-insurance-benefit\/ (2012, accessed 16 September 2019)."},{"key":"bibr31-17455065211017068","volume-title":"Multivariate data analysis: a global perspective","volume":"7","author":"Hair JF","year":"2010"},{"issue":"14","key":"bibr32-17455065211017068","first-page":"1","volume":"1","author":"Radha K","year":"2015","journal-title":"IOSR J Dent Med Sci"},{"key":"bibr33-17455065211017068","unstructured":"Llamas M. Hysterectomy: removal of the uterus. drugwatch, 21 April, https:\/\/www.drugwatch.com\/transvaginal-mesh\/hysterectomy\/ (2021, accessed 27 May 2021)."},{"issue":"9","key":"bibr34-17455065211017068","first-page":"553","volume":"54","author":"Erekson EA","year":"2009","journal-title":"J Reprod Med"},{"key":"bibr35-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1016\/S1353-8292(00)00011-3"},{"key":"bibr36-17455065211017068","doi-asserted-by":"publisher","DOI":"10.3109\/09286586.2014.884602"},{"key":"bibr37-17455065211017068","doi-asserted-by":"publisher","DOI":"10.13189\/ijrh.2013.010110"},{"key":"bibr38-17455065211017068","unstructured":"Devulapalli R. Secret behind rash of hysterectomies out. Times of India, 28 September, https:\/\/timesofindia.indiatimes.com\/city\/hyderabad\/Secret-behind-rash-ofhysterectomies-out\/articleshow\/16580758.cms (2012, accessed 5 November 2016)."},{"key":"bibr39-17455065211017068","unstructured":"Desai S. The effect of health education on women\u2019s treatment-seeking behaviour: findings from a cluster randomised trial and an in-depth investigation of hysterectomy in Gujarat, India (Doctoral dissertation, London School of Hygiene & Tropical Medicine), https:\/\/researchonline.lshtm.ac.uk\/id\/eprint\/2228561\/ (accessed 15 November 2019)."},{"key":"bibr40-17455065211017068","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15858"},{"key":"bibr41-17455065211017068","unstructured":"Government of India. National Policy for Women 2016: articulating a vision for empowering women (draft), Ministry of Women and Child Development (MoWCD), https:\/\/wcd.nic.in\/sites\/default\/files\/draft%20national%20policy%20for%20women%202016_0.pdf (2016, accessed 26 October 2019)."}],"container-title":["Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17455065211017068","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17455065211017068","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17455065211017068","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:31:53Z","timestamp":1777710713000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17455065211017068"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":41,"alternative-id":["10.1177\/17455065211017068"],"URL":"https:\/\/doi.org\/10.1177\/17455065211017068","relation":{},"ISSN":["1745-5057","1745-5065"],"issn-type":[{"value":"1745-5057","type":"print"},{"value":"1745-5065","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]},"article-number":"17455065211017068"}}