Ethnobotanical documentation, codification, and community-led management of medicinal plant diversity in the Khasi Hills region of Meghalaya, India

The Khasi Hills of Meghalaya, India, harbour rich traditional knowledge of medicinal plants, integral to local healthcare and cultural identity. These resources face threats from deforestation, climate change, and erosion of traditional knowledge. This study aimed to document and safeguard Khasi ethnobotanical practices. Between April 2023 and January 2024, an ethnobotanical survey was conducted across four Khasi Hills districts, involving 32 healers and informants. Data were collected via open and semi-structured interviews and analysed using Use Reports (UR) and Informant Consensus Factor (ICF), with diseases classified according to the International Classification of Primary Care-2 (ICPC-2). A total of 164 medicinal plant species from 131 genera and 71 families were documented, including six IUCN-listed threatened species: Cinnamomum verum, Citrus latipes, Nageia nagi, Nepenthes khasiana, Paris polyphylla, and Rauvolfia serpentina . Asteraceae and Zingiberaceae were the most prominent families, used for digestive, musculoskeletal, cardiovascular, and skin disorders. Leaves were the most used plant part, followed by whole plants, roots, and fruits. Medicinal preparations included pastes, decoctions, and juices, administered orally or topically. Disease codification linked plant use with 105 ailments across 16 categories, showing high consensus for respiratory, digestive, musculoskeletal, blood-related, and metabolic disorders. Comparative analysis with literature from Meghalaya ( 1980–2025) revealed 27% of species with newly reported uses and over 50% additional therapeutic applications. Community forests and village-managed areas ensure sustainable access, while women healers actively cultivate medicinal plants. Integrating codified ethnomedicinal knowledge into conservation and healthcare planning is essential to preserve cultural heritage, promote sustainable use, and guide pharmacological research.