The extremely high infant mortality rate in the outer islands of the Marshall Islands is being attributed to a number of factors.
The government's Director of Planning, Carl Hacker, describes the rate as astronomically high with infants in remote atolls dying at a rate of 90 per 1,000 births, compared to under 20 per 1,000 in the capital, Majuro.
These figures are among the highest in the world.
Mr Hacker says more than 90 percent of births take place in hospitals but a lack of post-natal care could result in the number of infants dying before they reach the age of one.
He also says most of the health assistants and medical officers in the outer islands are men.
"There's some real cultural issues with pregnant mothers going to see a male health assistant. Midwives - you know, I think it's something we're going to have to take a much more serious look at in terms of how we can use them and how we can get them involved. Two - is of course, there are no post-natal check-ups. When they go back to the outer islands, they're on their own."
Mr Hacker says there needs to be a revolution in the way the country approaches public health issues.
