Background:

The purpose of this research is to examine the evolution and the main aspects of the mortality rates of children under five years of age, from 1920 to 2009 in Costa Rica.

Methods:

Mortality rates for children under five years of age were calculated annually and by quinquennia, from 1920 to 2009. Up until 1950, the number of deaths was obtained from the Statistical Yearbooks of the National Institute of Statistics and Censuses, and from that year on, from the Central American Center of Population database. To calculate the mortality rate, we used the population of 0 to 4 years old.

Results:

When using the population of 0 to 4 year olds as a denominator, there was a 97.85 % drop in the mortality rate of children under five years old between 1920 and 2009 when analyzed annually, and a 97.18 % drop when analyzed by quinquennia. As for the percentage contribution of mortality in children under five of age to total mortality, the percentage dropped from 49.71 % in

1920, to 4.72 % in 2009, which accounts for a 90.5 % decline. The main causes of death varied markedly throughout the period in question; nutritional, parasitic and infectious diseases prevailed as the main causes in the past years, while nowadays, the main causes of death perinatal diseases and congenital malformations. In terms of the geographical distribution, during the period 2007-2011, on average, the provinces that had the highest mortality rates of children under five years old were Guanacaste, Puntarenas and Limón, while Heredia and Alajuela had the lowest.

Conclusions:

From 1920 to 2009, Costa Rica was able to achieve an enormous decline in mortality rate among children under five years of age; it dropped by more than 9 5%, which can be considered magnificent achievement in Costa Rican public health.

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