The Office of the Registrar General & Census Commissioner has released the Sample Registration System (SRS) Statistical Report 2024, documenting an accelerating demographic transition across India. The report confirms that India’s Total Fertility Rate (TFR) has declined to 1.9, placing the country firmly below the replacement fertility threshold of 2.1. This represents not merely a fertility decline but a structural demographic pivot, signalling that India is gradually moving from population expansion toward long-term stabilisation and demographic ageing.
The transition is visible across both rural and urban India. While fertility has fallen nationally, the decline remains uneven, with states such as Bihar continuing to record high fertility and regions like Delhi and Kerala already functioning within low-fertility demographic regimes. Simultaneously, the Crude Birth Rate (CBR) continues its multi-year downward movement, indicating that fertility moderation is increasingly broad-based rather than confined to a few urban centres.
Rural women (TFR 2.1) had, on an average, more children than urban women (TFR 1.5).
The report also records sustained improvements in survival outcomes. Infant Mortality Rate (IMR) has declined from 30 in 2019 to 24 in 2024, dropping by 1 point from 2023, while Under-5 Mortality Rate (U5MR) fell further to 28. These trends point to continuing gains in maternal healthcare access, immunisation coverage, institutional deliveries, and early-childhood interventions.
However, the demographic gains coexist with major healthcare asymmetries. While 95.4% of births received medical attention during delivery, only 40.2% of deaths involved medical care before death. This contrast reveals an uneven healthcare architecture: one that has substantially strengthened maternal and child survival systems but remains comparatively weak in geriatric care, chronic disease management, and end-of-life medical support. The gap is particularly acute in rural India, where nearly half of all deaths (48.9%) occur without medical attention.
Deaths from motor vehicle accidents deaths rose to 3.2% and deaths by suicide increased to 2.8%.
On the social front, the national Sex Ratio at Birth (SRB) registered a minor 1-point increase to 918 (females per 1,000 males) for the 2022-24 observation window, led by Chhattisgarh at a high of 978 and bottlenecked by Uttarakhand at a national low of 872.
The report further highlights persistent interstate and social disparities across fertility, mortality, and SRB indicators, indicating that India’s demographic transition is proceeding at different speeds across regions and social contexts.
Core Demographic Baselines (SRS 2024)
Vital Indicator | National | Rural | Urban | Highest State / Value | Lowest State / Value |
|---|---|---|---|---|---|
Crude Birth Rate (CBR) | 18.3 | 20.2 | 14.7 | Bihar (26.8) | Kerala (11.1) |
Total Fertility Rate (TFR) | 1.9 | 2.1 | 1.5 | Bihar (2.9) | Delhi (1.2) |
Crude Death Rate (CDR) | 6.4 | 6.8 | 5.6 | Chhattisgarh (8.4) | Delhi (4.5) |
Infant Mortality Rate (IMR) | 24 | 27 | 17 | Chhattisgarh (36) | Kerala (8) |
Sex Ratio at Birth (2022–24) | 918 | 914 | 928 | Chhattisgarh (978) | Uttarakhand (872) |
Healthcare and Mortality Access Indicators
The SRS findings reveal a sharp divergence between institutional birth care and medical support before death, suggesting that India’s public health expansion has been considerably more successful in protecting early-life outcomes than in building universal care systems across the full life cycle.
Under-5 Mortality Rate (U5MR): 28
Male U5MR change: -2 points YoY
Female U5MR change: -1 point YoY
Births receiving medical attention: 95.4%
Deaths receiving medical attention: 40.2%
Deaths in government hospitals: 24.7%
Deaths in private hospitals: 15.5%
Rural deaths without medical attention: 48.9%
Motor vehicle accidents increased: 3.2%
Deaths by suicide increased: 2.8%
What is the "Replacement Level of Fertility"?
The replacement level of fertility is the precise, threshold-level Total Fertility Rate at which a generation of women bears exactly enough children to replace themselves and their partners in the population without any net migration. Globally set at a baseline value of 2.1 children per woman, this metric accounts for the fact that slightly more boys are born than girls, and that not all children survive to complete their reproductive lifecycles. When a nation’s TFR falls below this 2.1 barrier, as India has achieved at 1.9, it signals that the country has crossed a permanent demographic pivot point. While the population will continue to expand for a limited period due to demographic momentum, the long-term structural trajectory shifts toward population stabilization and a gradual demographic aging profile.
Policy Relevance
Signals a Transition to Regional Aging Interventions: With 16 major states and UTs falling below replacement fertility, including ultra-low baselines like Delhi (1.2) and Kerala (1.3), the Ministry of Health must shift its focus from population control toward building robust geriatric healthcare pipelines and pension systems to support an aging demographic profile.
Exposes Severe Gaps in Cause-of-Death Reporting: The revelation that 45.5% of individuals pass away with zero medical attention poses a critical threat to the integrity of public health data, as it limits the state's capacity to accurately chart and counter non-communicable disease (NCD) hotspots due to unverified medical causes of death.
Validates National Institutional Delivery Schemes: Hitting a 95.4% institutional delivery rate provides concrete proof of the success of structural interventions like the Janani Suraksha Yojana, confirming that public health infrastructure has successfully brought nearly all maternal childbirths inside formal clinical safe zones.
Demands Targeted Child Survival Inputs in Specific States: The fact that one in every 42 infants still dies within their first year of life nationally, peaking inside states like Chhattisgarh with an IMR of 36, indicates that the MoHFW must deploy specialised neo-natal care units into high-burden pockets to sustain the child survival curve.
Corroborates Education-Linked Family Planning Efficacy: The correlation showing lower fertility behavior paired with higher female education levels justifies expanding fiscal allocations toward secondary and higher education for girls under the Beti Bachao Beti Padhao framework as an indirect economic driver of demographic stability.
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