By Sandra Albert and Glenn Kharkongor
Initiatives by the State department of health have led to major improvements of public health in the state. These were supported by various research and community projects conducted by institutions of higher education. The top five public health breakthroughs in Meghalaya in 2025 were:
1. Improvement in maternal and child health
For decades the women of Meghalaya had suffered from poor maternal services resulting in high maternal mortality and reflecting poor antenatal care, iron-deficiency anemia, high teenage pregnancies, and low institutional deliveries.
Meghalaya’s State Health Policy, 2021, given the acronym MOTHER (Measurable Outcomes in Transforming Health sector through a holistic approach with focus on women’s EmpoweRment) placed emphasis and focus on maternal health. The Government’s rescue mission reviewed maternal deaths and identified a list of problems. These were taken up through the CMSMS scheme (Chief Minister’s Safe Motherhood Scheme) by a set of initiatives to improve services. These ranged from upskilling health care professionals in Emergency Obstetric Care (EmOC) to equip healthcare providers (like MBBS doctors) with skills to manage life-threatening complications during pregnancy, childbirth, and postpartum.
At the community level, a welcome initiative was the provision of transport for pregnant women to reach a health care facility for delivery. Transit homes were also established for those who lived in remote places. The Mother App helped track health status of pregnant women to improve follow-up of high-risk pregnancies. These measures and wage compensation up to Rs 1000 helped increase Institutional deliveries to more than 70%.
As a result, maternal deaths fell from 228 in 2021-22 to 96 in 2025. Neonatal and infant mortality also declined during this period. Meghalaya’s health policy aligns with Sustainable Development Goal 3.2, which aims to reduce Neonatal Mortality Rate, Infant Mortality Rate, and the Under-5 Mortality Rates to national target levels by 2030.
Note: the neonatal mortality rate (NMR) pertains to deaths within the first 28 days of life per 1,000 live births, infant mortality rate (IMR) refers to deaths in the first year of life per 1,000 live births, and the under-five mortality (U5MR) rate is based on deaths in the first five years of life per 1,000 live births. The maternal mortality rate (MMR) is measured by the number of maternal deaths due to pregnancy, labour and delivery per one hundred live births among women aged 15-49 years.
Meghalaya’s governance model in maternal health received the jury favourite award at the Creative Bureaucracy Festival held in Berlin, Germany, in June 2025. Meghalaya’s entry was cited for effectively blending policy innovation with grassroots implementation, while prioritising dignity, care, and inclusivity. The Creative Bureaucracy Festival, known for highlighting people-driven innovations in governance, featured participants from over 50 countries. The award was received by Dr Sampath Kumar, IAS, principal secretary, health.
2. Immunization rates have markedly increased
Childhood vaccination remains one of the most cost-effective means of reducing child mortality. The Universal Immunization Programme (UIP) of the Government of India provides free vaccinations against diseases like tuberculosis, pertussis (whooping cough), measles, diphtheria, tetanus, polio, hepatitis B, and newer vaccinations against rotavirus diarrhoea and pneumococcal pneumonia. In recent years, there has been a dramatic rise in childhood immunization from under 60% to near 90%+ coverage.
Infant mortality from infectious diseases has fallen considerably in recent years. But there are other less known factors. A study by the Indian Institute of Public Health Shillong (IIPHS) and the Ministry of Health demonstrated that vit B1, thiamine deficiency among mothers was leading to infantile beriberi, which may lead to death from cardiac failure. Thiamine given to mothers is a cost effective intervention that can save lives, and the state government has rolled out a supplementation programme. The Early Childhood Mission is working on several interventions to improve wasting and stunting among children.
3. Traditional healing is being mainstreamed
The Meghalaya Mental Health and Social Care Policy, 2022, is the first such state policy in India. The policy mentions the word ‘culture’ 72 times and the word ‘traditional’ 27 times, indicating that the policy is grounded in cultural and traditional healing approaches.
The state health department commissioned the NICE Institute for Family Health, Hyderabad to conduct training of traditional birth attendants (TBAs) in the Garo Hills and Jaintia Hills. More than two hundred TBAs were trained in the health monitoring of women in pregnancy, conducting deliveries and care of the newborn infant.
A book “Tribal Health and Wellbeing in Meghalaya, India” was published by Martin Luther Christian University (MLCU) in June 2025, which highlights the need to integrate traditional health practices with formal healthcare. The book was funded by a grant from the Rosa Luxemburg Stiftung Foundation, Germany.
4. Adolescent health and wellbeing
The Meghalaya Programme for Adolescent Wellbeing, Empowerment and Resilience (MPOWER) is a World Bank-supported, multi-sector initiative under the Meghalaya Basin Development Authority (MBDA). It aims at improving the well-being, empowerment, resilience, and future prospects of adolescents aged 9–19 in the state. The goal to improve human capital outcomes of adolescents is pursued through three themes: life skills education, mental health, and career guidance.
It aims to achieve its objectives by reducing school dropout rates, improving learning outcomes, strengthening life skills, mental health awareness, and career preparedness. It will support out-of-school adolescents to re-engage with education or work pathways and promote sexual and reproductive health education to reduce teen pregnancies.
The project is expected to benefit around 500,000 adolescents across Meghalaya, both in-school and out-of-school, and uses an age-based skills and competency framework to guide interventions and outcomes. MLCU has developed the framework in coordination with the World Bank and the departments of Social Welfare and Education. The first step of training master trainers will be conducted by MLCU in early 2026.
5. Leptospirosis and scrub typhus
Meghalaya’s hilly, forested terrain, teeming with mammals, where people raise livestock alongside crops, is an ideal setting for germs to jump from animals to humans. Northeast India has emerged as one of the country’s hotspots for zoonotic diseases, responsible for more than a third of all reported outbreaks between 2018-23.
On October 21, 2025, Nature India broke the story of a new surveillance system in Meghalaya to track regional epidemic diseases. This is a five-year project of IIPHS in collaboration with CMC Vellore and the Indian Council of Agricultural Research, Shillong, funded by the DBT/Wellcome Trust India Alliance.
The story is taking shape at the Zoonotic and Vector-borne Disease Centre (ZVBDC) at IIPHS.
NESAC, ISRO supports the team at IIPH Shillong by offering training and expertise in Remote Sensing and GIS Tools for epidemic surveillance. The ZVBDC tracks diseases in real time using a One Health approach. For the first time, human leptospirosis has been diagnosed in Meghalaya. Ten laboratory-confirmed cases were reported in the Dec 2025 issue of the Indian Journal of Medical Research by a team of investigators from Roberts Hospital and IIPHS.
Leptospirosis is a zoonotic disease, which means it’s transmitted between animals and humans. Infection can be caught by contact with animal urine or reproductive fluids from infected animals such as rats, dogs, horses, pigs, and cows. Leptospirosis is treatable by appropriate antibiotics, and early treatment can prevent severe complications.
Scrub typhus is an infectious disease caused by bacteria from the bite of mites found in scrub and forested areas. There is sudden high fever, headache, muscle pain, and a dark scab at the bite site. Without early treatment with antibiotics, it can lead to severe complications and even death.
Over the past few years, Meghalaya has made measurable progress in healthcare. Despite progress, mortality rates in Meghalaya remain above the national averages, highlighting the need for continued investment in healthcare accessibility. Challenges of vaccine hesitancy persist in some areas due to fears, myths and or religious beliefs. Geographic and last-mile challenges continue because of remote terrain and scattered populations.
