[Infant mortality in Croatia 1993-2002]

In Croatia, infant mortality has been registered since 1874. During this period of time, a tremendous decline was recorded from 295.2/1000 live births in 1874 to 7.0/1000 live births in 2002. A tenfold decline was recorded during the second half of the 20th century. In the last years, the decline has been slower. Significant differences were found among counties according to different years.

The aim of the study was to analyze data on a ten-year period (1993-2002), to calculate total mortality rate for the country as a whole and for each county in separate, and to discuss the leading causes of infant death.

Mortality statistics data (death registers supplied by the Central Bureau of Statistics and Croatian National Institute of Public Health) were analyzed. The rate per 1000 and percentage were calculated for the four main death causes in each county.

The mortality rate for Croatia was 8.4 for the ten-year study period. Nine counties had rates above and 11 counties below the rate for whole Croatia. The highest mortaliry rate was in Medimurje County (13.3) and lowest in Zagreb County (6.7). The leading causes of infant deaths in the whole country except for Medimurje County were perinatal causes (XVI according to ICD 10), followed by congenital malformations (XVII), symptoms (XVIII) and injuries (XlX). In four counties (Karlovacka, Bjelovarsko-Bilogorska, Viroviticko-Podravska and Istarska), the third and fourth causes exchanged their places. The exception was Medimurje County where respiratory diseases ranked second (X), congenital malformations third and symptoms fourth. During ten years, 96 infants died because of injuries, calling for additional intervention to decrease the rate of these avoidable deaths in mainly healthy children. Data on ethnicity of dead infants were not available, so we could only presume that the difference in the Medimurje County was due to the greater proportion of Gypsies in the area.

Further analysis is needed, taking into account the socioeconomic and ethnic data which are usually lacking in death certificates although anticipated to collect them. In conclusion, there is space for further decreasing infant mortality in Croatia. Analysis and intervention because of the great differences between counties are necessary, with special reference to Medimurje County because of its highest rate and quite a different pattern of infant deaths from other counties.