Meghalaya's Rescue Mission

Turning Maternal and Infant Deaths from “Inevitable” to Preventable

The starting point

The Rescue Mission was launched in November 2020, after weekly COVID-era reviews brought the state’s high number of maternal deaths to the attention of senior political and administrative leadership. In 2020-21, Meghalaya recorded 244 maternal deaths, corresponding to a Maternal Mortality Ratio (MMR) of about 295 per 100,000 live births. Geography compounded the problem: roughly a quarter of the state’s nearly 7,000 villages were classified as hard-to-reach, and residents of 49% of villages could not reach a health facility within 30 minutes by vehicle. But the state’s own assessment found the deeper barrier was mindset — these deaths had long been treated as unfortunate but unavoidable rather than as a problem the system could collectively solve.

MRM Starting Point

What changed

Rather than a single vertical programme, Meghalaya worked on several parts of the system at once. The MOTHER App put individual-level tracking of every pregnant and lactating woman in the hands of Medical Officers and frontline workers in real time, allowing high-risk cases to be flagged and followed up. The Chief Minister’s Safe Motherhood Scheme (CM-SMS), launched in July 2022, gave facilities flexible funds for transport support and transit homes run by Self-Help Groups (SHGs), with traditional birth attendants incentivised to refer high-risk women. A dedicated recruitment board set up in October 2022 brought in 380 Medical and Health Officers, 108 Junior Specialists, 163 Staff Nurses and 110 ANMs, cutting recruitment cycles to 20–40 days, while blame-free monthly maternal and infant death reviews were institutionalised into a standing learning loop.

That is a 56–57% fall in maternal deaths and a roughly 40% fall in infant deaths since November 2020. The SHSRC learning note cautions that the 2020-21 peak partly reflects COVID-19 and improved reporting after the Mission began, so the true decline is best read alongside trend data rather than from the two endpoints alone.