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Hysterectomies to be included in health survey



Updated On - Monday, 26 August 2013

20 August 2013

The government will collect information on hysterectomies in the fourth round of the National Family Health Survey (NFHS), which begins in January 2014.

The decision to include hysterectomies as a component in the NFHS-4 was taken at the steering group meeting on NFHS here on Monday. The move comes in the wake of a demand from the health activists and medical practitioners following reports of rising cases of hysterectomies across the country.

The matter was taken up at a meeting of stakeholders last week following which activists wrote letters to the Health and Family Welfare Ministry, and Planning Commission demanding inclusion of hysterectomies in NFHS-4. It was pointed out that unscrupulous doctors were performing hysterectomies on pre-menopausal and even women younger than 30 years for monetary gains.

Hysterectomy is the complete or partial removal of the uterus, and sometimes ovaries, cervix and fallopian tubes. Ethically, a doctor should suggest this operation in case of certain medical conditions, or when all other treatment options fail.

The data generated during the NFHS could be used for formulating guidelines to conduct surgeries for removing the uterus.

Expressing happiness over the decision, Chhaya Pachauli, a health activist with Chittoor-based non-governmental organisation called Prayas said it was an important step forward as it would show the exact incidence of hysterectomies in India. As of now, there are no exact statistics to show the prevalence rate of these operations, largely believed that they are the second most common surgeries performed on women, second only to caesarean sections. The rising concern is not just about the high expenditure and medical ethics, but also about the complications and troubles that follow. Hysterectomy may have a significant impact on woman’s health.

A Right to Information Act (RTI) application filed in Dausa in Rajasthan revealed that between April and October 2010, out of a total of 385 operations reported by three private hospitals, 286 were hysterectomies. Many of these women were under the age of 30, with the youngest being 18.

The findings of a study done by Dr. M.Prakasamma in two districts of Andhra Pradesh on tubectomy and hysterectomy suggest these are contradictory in terms of place of operation. Majority of tubectomies are performed in public health system whereas 89 per cent of hysterectomies were conducted in private.

“This indicates that the public health system is meant only for national programme and less interested in other health programme. This also raises questions whether hysterectomies are justified and whether the higher percentage of hysterectomies in the private sector reflect economic and commercial interest of some groups,’’ he says.

On their part, the Indian Medical Association and the Federation of Obstetric Gynaecological Societies of India (FOGSI) have initiated a process of drawing Standard Operating Procedures (SOP) and these should be available in the public domain by December.

“We need to develop more stringent guidelines for conducting hysterectomies. The FOGSI is planning to launch a hysterectomy registry that would help in creating a data bank and also auditing these surgeries,’’ says Hema Divakar, president of FOGSI.

Published by: The Hindu

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