The infant mortality rate in 2009 was 6 deaths per 1000 births, and life expectancy at birth in 2009 was 75 years. With the aim of developing Malaysia into a medical tourism destination, 5 per cent of the government social sector development budget is spent on health care. The number of live births in Malaysia stood at 508,203 babies in the year 2016. This is a decline compared to 521,136 the previous year. There was also a decline in crude birth rate from 16.7 (2015) to 16.1 (2016) per 1,000 population. Male babies account for 51.7% of all babies born in the year 2016. The highest crude birth rate was reported at Putrajaya (30.4) and the lowest was reported at Penang (12.7). The Julau district has the highest crude birth rate nationwide at 26.9 per 1000 population, meanwhile, the lowest crude birth rate was recorded in the Selangau district. The total fertility rate in Malaysia remains below the replacement level at 1.9 babies in 2017. This is a decline of 0.1 compared to the previous year. The highest crude death rate was reported in Perlis at 7.5 per 1000 population and the lowest crude death rate was reported in Putrajaya (1.9) in 2016. Kuala Penyu was the district with the highest crude death rate while Kinabatangan recorded the lowest crude death rate in the country.