What has India done to curb unnecessary hysterectomies?

Source: The post is based on the article “What has India done to curb unnecessary hysterectomies?” published in The Hindu on 30th May 2023

What is the News?

The Union Health Ministry recently urged State governments to audit hysterectomy trends in public and private hospitals.

What is Hysterectomy?

A hysterectomy is a surgery to remove the uterus. After a hysterectomy, one will not menstruate (have periods) or be able to get pregnant.

According to NFHS-5 data, highest percentage of hysterectomies were to treat excessive menstrual bleeding or pain (51.8%); 24.94% for fibroids; 24.94% for cysts and 11.08% for uterine disorder or rupture. A majority of these cases were reported among socially and economically disadvantaged women. But, studies have shown that “many of these causes were considered to be treatable and surgery could be avoided.”

In some cases, women may continue to suffer post-surgery and might need additional surgery. In other cases, patients may need medical support such as hormone replacement therapies. But these interventions are limited to private hospitals and remain unaffordable for low-income groups.

About the Supreme Court’s directions and the Center’s request

Must read: Take steps to reduce unnecessary hysterectomies, Centre tells States

What are the government measures against Hysterectomy?

The Union Health Ministry in 2022 issued guidelines to prevent unnecessary hysterectomies. The guidelines a) listed possible indications of when a hysterectomy may be required and alternative clinical treatments for gynaecological issues, b) recommended setting up district, State-level and national hysterectomy monitoring committees to monitor and collect data on age, mortality, and occupations, among other details, c) tasked monitoring committees with creating awareness, among both practitioners and patients, about bodily anatomy.

The government’s flagship health insurance programme, the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana provides health cover of ₹5 lakh for 1,949 procedures, including hysterectomies.

What are the reasons for increasing hysterectomy surgeries?

The false assumption regarding health: A 2017 study from Gujarat found most women assumed that the uterus served no role outside of pregnancy and that removing the uterus would solve their health issues.

Misuse: The procedure can easily be misused by either private clinics that earn profits (from insurance money) or by contractors in unorganised sectors such as the sugar-cane-cutting industry, where ‘wombless women’ are the norm to eliminate the need for menstrual care and hygiene among workers.

Looked as a way to become productive: A 2019 investigation found that women from rural areas look at hysterectomies as a way of increasing days of productive work and earning more wages.

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