Gender-Responsive Climate Change Adaptation: Policy Framework and Indigenous Knowledge Systems for Maternal Health Resilience in Meghalaya, Northeast India

Maternal health in Meghalaya particularly in the Khasi Hills continues to suffer from structural inequities, weak institutional outreach, and increasing climate-related stress. Despite the presence of a matrilineal kinship system and deeply embedded Indigenous medicinal knowledge, traditional maternal health practices remain largely excluded from formal health policy. This study investigates the interface between Khasi Indigenous health systems and state-led biomedical care in the context of climate change. In this context, the study addresses three key research questions: (1) What structural and policy barriers hinder the formal recognition of Indigenous maternal health knowledge? (2) How can women-led institutions such as the Seng Kynthei strengthen maternal health outcomes under climate stress? (3) What hybrid models can support pluralistic, climate-adaptive healthcare systems? Using qualitative methods, including literature review, policy analysis, and interviews with traditional healers, women leaders, and health workers, the study maps existing synergies and gaps. Findings indicate that integration of Indigenous practices with formal systems—particularly through culturally anchored women’s groups—can enhance maternal resilience. The study concludes by suggesting policy recommendations for inclusive, gender-responsive health systems that leverage traditional knowledge to meet the dual challenges of climate vulnerability and maternal health inequity.