A new report suggests that a mentality of dependence on the United States is stunting the progress of development in the Marshall Islands, despite high levels of aid.
The Asian Development Bank says the country has one of the highest per capita gross domestic products amongst all its member countries which are developing nations in the Pacific.
But the bank reports that infectious and lifestyle diseases are at close to epidemic proportions, the rate of infant and child mortality is high, teenage pregnancies are increasing, alcohol and tobacco use are high, and the rate of suicide is alarming.
On the economic front, the lack of employment opportunities lead to a sense of futility and erodes people's self worth,
The ADB strongly recommends a focus on greater community participation in development processes to raise ownership and the demand for social and economic progress.
This year, the 55,000 islanders have a national budget of US$114 million, more than 60 per cent of which is provided by the US government.