{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T11:41:55Z","timestamp":1779277315976,"version":"3.51.4"},"update-to":[{"DOI":"10.12688\/wellcomeopenres.23084.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000}}],"reference-count":35,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009053","name":"Wellcome Trust DBT India Alliance","doi-asserted-by":"publisher","award":["IA\/TSG\/21\/1\/600324"],"award-info":[{"award-number":["IA\/TSG\/21\/1\/600324"]}],"id":[{"id":"10.13039\/501100009053","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns3:p>Hysterectomy, removal of the uterus, is a commonly performed surgery for gynaecological morbidities. Emerging evidence indicates that hysterectomy performed before age 45 (early hysterectomy), is associated with considerable risks to women\u2019s health. While most evidence on hysterectomy is from high-income settings, national surveys from India report high prevalence of early hysterectomy in specific regions, as well as higher prevalence amongst women in rural areas and with less education. The median age at hysterectomy in India is close to ten years before the onset of natural menopause. India has recently introduced national guidelines to address early hysterectomy, but large evidence gaps on the causes and consequences remain \u2013 which in turn limits the potential effectiveness of interventions at the clinical, health system and community level. Methods SAHELI is a Team Science study that will examine: (i) individual, social and health system determinants of early hysterectomy; (ii) women\u2019s treatment pathways to hysterectomy and for gynaecological morbidity in general; and (iii) the consequences of undergoing hysterectomy on women\u2019s physical, mental, economic and social well-being across the life course. This mixed-methods study includes population surveys amongst women in ages 25\u201349 in three high-prevalence states; qualitative health systems research to trace treatment journeys with women, health care providers and other stakeholders; evidence syntheses; and knowledge translation activities to ensure findings inform co-produced strategies and interventions. The study is grounded in a feminist epidemiology approach, aiming to examine individual and structural causes of vulnerability and prioritising the views of women, particularly in knowledge translation. Conclusions SAHELI, implemented by an all-women, multi-disciplinary team, is the first study in India to examine the causes and consequences of hysterectomy in a life course approach. We aim to influence interventions, policy and future research on women\u2019s health, particularly access to quality gynaecological care and comprehensive health services through the life course.<\/ns3:p>","DOI":"10.12688\/wellcomeopenres.23084.2","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T18:55:11Z","timestamp":1741200911000},"page":"584","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["SAHELI:\u00a0 Study and Action on Hysterectomy: Evidence on women\u2019s health through the life course in India.\u00a0 Protocol for a mixed-methods study"],"prefix":"10.12688","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2596-9726","authenticated-orcid":false,"given":"Sapna","family":"Desai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0599-0045","authenticated-orcid":false,"given":"Dipti","family":"Govil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5682-6109","authenticated-orcid":false,"given":"Devaki","family":"Nambiar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2386-1383","authenticated-orcid":false,"given":"Hemali 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Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/9-584\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/9-584\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/9-584\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T18:55:15Z","timestamp":1741200915000},"score":1,"resource":{"primary":{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/9-584\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,5]]},"references-count":35,"URL":"https:\/\/doi.org\/10.12688\/wellcomeopenres.23084.2","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/wellcomeopenres.23084.1","asserted-by":"subject"}]},"ISSN":["2398-502X"],"issn-type":[{"value":"2398-502X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,5]]},"assertion":[{"value":"Indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/9-584\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.25420.r110281, Anupama Bahadur, All India Institute of Medical Sciences, Rishikesh, 26 Nov 2024, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/9-584\/v1#referee-response-110281","order":0,"name":"referee-response-110281","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Sapna Desai<\/b>; \n<i>Posted: 21 Feb 2025<\/i>; Thank you for your encouraging responses.&nbsp; We will ensure to&nbsp;share our findings with you and the gynaecologist&nbsp;community early on, to ensure the study can support development of feasible interventions to address early hysterectomy that is not medically indicated.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/9-584\/v2#referee-comment-6050","order":1,"name":"referee-comment-6050","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.25420.r115543, Elizabeth Bertone-Johnson, Health Promotion and Policy, University of Massachusetts, Amherst, MA, 21 Dec 2024, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/9-584\/v1#referee-response-115543","order":2,"name":"referee-response-115543","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Sapna Desai<\/b>; \n<i>Posted: 21 Feb 2025<\/i>; Thank you for your encouraging review of this protocol.&nbsp; As of December 2024, we&nbsp; completed our inception phase, including formative research and community engagement.&nbsp; We just finalised research sites, and are currently preparing for the survey to be initiated in March 2025.&nbsp; We will also update the study protocol after this phase is completed.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/9-584\/v2#referee-comment-6051","order":3,"name":"referee-comment-6051","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by Wellcome IA\/TSG\/21\/1\/600324 through the DBT-Wellcome Trust India Alliance. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}