ew The key data items to note are: a) 47.7% of the total populatiogq are under 15 years of age (59% under 20 years of age), b) only 8.6% of the pbpulation are over 55 years of age, and c) 74.1% of all females are under 30 These data show that pregnant women, children, the main target groups and young people. ypars of age. for health care are The biologidal potential (fecundity) of this young population is also highly apparent. Though it would seem that health care problems of the elderly would belminor, it is not quite the case here as in many developing countries becausp of the much higher than normal incidences of specific chronic diseases i.e.idiabetes and hypertension (discussed later). Other key vital | statistics for the Marshall Islands [in 1976 are summarized below (Source: TTPI Five Year Comprehensive Health phan, April 1, 1980) Crude birth rate 31.1 Crude death rate 4.2 Infant mortality rate = 17.9* Maternal mortality rate = 27.0 (1974-1976) R. Natural Increase = 26.9 *Infant mortality would probably be in the upper 20's ta low 30's if there were better reporting. Also a child is historically|considered a _ live birth only after his first birthday. In general the Marshall Islands do not compare badly with mamy developing countries in “infant mortality" yet it still is significant. natural increase" jis quite planning are obvious. considerably. is though. The implicationg for family Unfortunately the level of family stand ing services delivered has been low. among males high [The "rate of low to Perception of need for family planrfing services non-existent, though women's percepfions differ The need for better integration of family panning into ongoing maternal and child health services needs to be done, aq well as the development of a concerted culturally sensitive educational campaign. The geographical distribution of the population demographic factor to consider in health care delivery. is Jalso a key (Seef Table 3) In 1977 it was estimated that 57% of the total population resided @ither in the “district center" (Majuro - 10,087 or 39%) or in the “subdistrict center" (Ebeye - 18% or 4,577). Arno atoll classifies as an “interma@diate zone", and had 1,199 inhabitants or 5% of the population (it lifes just] 35 mites by water from Majuro); while the remainder of the atolls or “outer islands” contained 38% of the population or a total of 9,594. The mapjon the next page gives the last known totals of inhabitants by atoll] as distances from Majuro. well as water 3 As