According to the latest Sample Registration System (SRS) statistical report, almost half of all deaths recorded in 2024 occurred without medical attention from a trained professional. Such deaths accounted for 45.5% in 2024 – more than double the 18% recorded in 2020 – and remain close to half of all deaths since 2021.This category includes people who did not receive any medical assistance at the time of death, or who were cared for only by an untrained person. In practice, this often indicates deaths occurring at home or outside formal medical care, although the place of death is not mentioned.The sudden and sustained surge is difficult to explain from published data alone. The increase in such deaths may reflect poor access to health care, 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 the way medical presence at death is classified or reported. TOI sought comment from the office of the Registrar General of India, which conducts the SRS, but did not receive any response.

Bihar tops in deaths without medical care

The rural-urban divide supports the possibility that access to health care plays a role. In 2024, the proportion of deaths without trained medical care was significantly higher in rural areas, 48.9%, than in urban areas, 36.1%.This pattern has been consistent since 2014 and is applicable in all states.

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State-level data also shows wide variation. The proportion of deaths without trained medical care in 2024 was lowest in Kerala, at 26.8%, and Jammu and Kashmir, at 29.2%. The percentage was highest in Bihar at 67.8%, Jharkhand at 61.8% and Chhattisgarh at 60.4%. This trend is surprising as it comes after years of expansion in hospital infrastructure, health insurance schemes and public health programs across the country.Nearly a quarter of all deaths in 2024, or 24.7%, occurred in government hospitals, down slightly from the 27% recorded in 2014.From 2014, the share of deaths in government or private hospitals has steadily increased until 2020, when 30% of deaths occurred in government hospitals and 19% in private hospitals. Since then it has fallen.Overall, the share of deaths in government and private hospitals in 2024 was broadly similar to 2014 levels. But where medical help was received from a “qualified professional”, the proportion of deaths fell sharply – from 35% in 2014 to 14% in 2024.Public health experts say the findings underscore persistent inequities in access to health care, especially in rural and poor areas.