This report presents the findings of the primary health care (PHC) system in the Republic of the Marshall Islands (RMI), an assessment that the World Bank conducted in consultation with the Ministry of Health and Human Services (MHHS) of the government of RMI. The assessment provides an opportunity to understand the performance of RMI’s PHC system, highlighting important areas of strengths and opportunities to address ongoing challenges. The assessment uses the Primary Health Care Performance Initiative (PHCPI) framework, which organizes various domains and subdomains of primary care using a logic model approach that encompasses the traditional inputs and outputs of a system, emphasizing service delivery and performance.The PHCPI uses technical tools to help countries improve the performance of their PHC systems. Its conceptual framework, which was developed to describe the critical components of a strong health care system, defines five core domains of a PHC system and serves as the foundation of the initiatives activities. The framework is operationalized into the Vital Signs Profile (VSP), which provides a snapshot of PHC systems in individual countries and states, revealing where systems are strong and where they have challenges. It is designed to help countries, states, and development partners identify priority areas for improvement and to track improvements over time.