Spatial analysis of infant mortality in Peninsular Malaysia over three decades using mixture models

Abstract

Infant mortality is one of the central public issues in most of the developing countries. In Malaysia, the infant mortality rates have improved at the national level over the last few decades. However, the issue concerned is whether the improvement is uniformly distributed throughout the country. The aim of this study was to investigate the geographical distribution of infant mortality in Peninsular Malaysia from the year 1970 to 2000 using a technique known as disease mapping. It is assumed that the random variable of infant mortality cases comes from Poisson distribution. Mixture models were used to find the number of optimum components/groups for infant mortality data for every district in Peninsular Malaysia. Every component is assumed to have the same distribution, but different parameters. The number of optimum components were obtained by maximum likelihood approach via the EM algorithm. Bayes theorem was used to determine the probability of belonging to each district in every components of the mixture distribution. Each district was assigned to the component that had the highest posterior probability of belonging. The results obtained were visually presented in maps. The analysis showed that in the early year of 1970, the spatial heterogeneity effect was more prominent; however, towards the end of 1990, this pattern tended to disappear. The reduction in the spatial heterogeneity effect in infant mortality data indicated that the provisions of health services throughout the Peninsular Malaysia have improved over the period of the study, particularly towards the year 2000.