During HDLP field visits conducted on May 23, 2025, in Mawthadraishan Block, Eastern West Khasi Hills, teams comprising MCS officers and sectoral staff interacted with multiple households to assess service uptake and community-level gaps in maternal and child health.
Key Finding:
A notable gap was observed in the timely registration of pregnancies—with over 50% of mothers reporting they had not registered during the first trimester. In many cases, registration occurred only in the second or even third trimester, limiting the effectiveness of antenatal care.
Concerns:
Early registration is vital to ensure:
- Timely initiation of iron and folic acid supplementation.
- Access to institutional delivery planning and risk identification.
- Health education and birth preparedness.
The delay increases the risk of maternal complications and neonatal issues, and often leads to missed immunisation schedules for newborns.
Contributing Factors:
- Low awareness of the importance of first-trimester ANC.
- Cultural hesitation in announcing pregnancies early.
- Lack of proactive home visits by frontline workers in certain areas.
- Geographic barriers limiting access to health sub-centres.
Positive Outlook:
Several women expressed willingness to register earlier once informed. ASHAs and AWWs accompanying the teams were responsive and committed to stepping up outreach efforts.
Recommendations:
- Strengthen household-level counselling on early pregnancy care.
- Incentivise ASHAs for timely identification and registration of pregnancies.
- Integrate birth registration awareness into Village Health and Nutrition Days (VHNDs) and Self-Help Group meetings.
- Mobilise community health platforms to dispel stigma and encourage early engagement with services.
The HDLP visit to Mawthadraishan has underscored the need to prioritise early maternal care through first-trimester registration. With renewed focus on communication, trust-building, and outreach, this block can make meaningful progress in ensuring safer pregnancies and healthier outcomes for mothers and children.