The Marshall Islands are an archipelago of 29 low-lying atolls and islands in the Pacific Ocean. With a total population of 42,000 in 2023, the life expectancy at birth was 65 years in 2022. The Marshall Islands vulnerability to the threats of rising sea levels, droughts, wave-driven floods and tropical storms make them highly susceptible to impacts of climate change.
The Marshall Islands face considerable public health challenges. With limited natural resources to support its population, the country struggles with inadequate drinking water supplies, sewage systems and essential infrastructure. Access to quality health care remains a significant issue, often necessitating travel to urban centres within the nation or even internationally.
The Marshall Islands experience high rates of mortality and morbidity from both communicable and noncommunicable diseases (NCDs). Ischemic heart disease, stroke, diabetes and tuberculosis are the leading causes of death. Additionally, tuberculosis remains a significant cause of death, with cases of multidrug-resistant tuberculosis also reported.
Climate-induced extreme weather events and rising sea levels are driving a range of health challenges, including an increased risk of waterborne and vector-borne diseases, heightened food and water insecurity leading to nutritional deficiencies, and disruptions to health systems.
Health services and infrastructure
The country’s health service infrastructure consists of two hospitals – one in Majuro, one in Ebeye – and 56 health care centres spread across the atolls and islands. Patients requiring extensive tertiary care are referred overseas.
The Marshall Islands have a national health insurance plan offering basic and supplemental coverage, but the quality and availability of services are inconsistent. Shortages of medical equipment, supplies and facilities limit health-care delivery. Providing health care across remote islands and atolls poses difficulties. All Marshallese citizens are eligible for the basic insurance plan with copayments.
Health care financing and strategic planning
While health outcomes have improved, the Marshall Islands still lag behind global averages. The government is committed to addressing the following priorities: achieving access to health care for all, addressing NCDs and building resilience to health threats, including climate change, health emergencies and disease outbreaks.
[1] World Health Organization, Global Health Expenditure Database, Health Expenditure Profile (choose country)