Few long-term statistical series exist that can document the mortality transition in Africa. This paper uses data from the parish registers of the Evangelical Lutheran Church in Namibia to study morality in Ovamboland between 1930 and 1990. The paper identifies significant discontinuities and reversals in the trend in mortality. Much of the mortality transition occurred in a rapid breakthrough concentrated between the early 1950s and early 1960s. Adult mortality fell more than existing model life tables would predict and the pattern of relatively high early-age mortality typical of modern Africa emerged only at this time. While a range of developments in Ovamboland contributed to the overall decline in mortality, the most important factor was the establishment, by the Finnish Mission, of a Western system of health care. In Ovamboland, the drive to 'good health at low cost' was articulated not through political institutions but through the church.