Nearly half of all deaths recorded in 2024 occurred without medical attention from a trained professional, according to the latest Sample Registration System (SRS) Statistical Report.

The share of such deaths was 45.5% in 2024 - more than double the 18% recorded in 2020 - and has remained close to half of all deaths since 2021.This category includes people who received no medical attention at the time of death, or were attended to only by an untrained person. In practice, this often indicates deaths at home or outside formal medical care, though the place of death is not mentioned.The sudden and sustained jump is difficult to explain from the published data alone.

A rise in such deaths can reflect poor access to healthcare, high costs of treatment, or weak enforcement of death reporting. But the scale and speed of the increase after 2020 also raises the possibility of changes in how medical attendance at death was classified or reported. TOI sought a response from the office of the Registrar General of India, which conducts SRS, but received no reply.

Bihar tops deaths sans medical care

The rural-urban split supports the possibility that access to healthcare plays a role.

In 2024, the proportion of deaths without trained medical attention was considerably higher in rural areas, at 48.9%, than in urban areas, at 36.1%.This pattern has been consistent since 2014 and holds across states.

State-level data also shows a wide gap. Kerala, at 26.8%, and Jammu & Kashmir, at 29.2%, had the lowest proportion of deaths without trained medical attention in 2024. Bihar, at 67.8%, Jharkhand, at 61.8%, and Chhattisgarh, at 60.4%, had the highest.

The trend is striking because it comes after years of expansion in hospital infrastructure, health insurance schemes and public healthcare programmes all across the country.About a quarter of all deaths in 2024, or 24.7%, occurred in govt hospitals, only slightly lower than the 27% recorded in 2014.From 2014, the share of deaths in govt or private hospitals had risen steadily till 2020, when 30% of deaths occurred in govt hospitals and 19% in private hospitals.

It has fallen since.Overall, the 2024 share of deaths in govt and private hospitals was broadly similar to the level in 2014. But the proportion of deaths where medical attention was received from a “qualified professional” fell sharply — from 35% in 2014 to 14% in 2024.Public health experts say the findings underline persistent inequalities in access to healthcare, especially in rural and poorer regions.