Abstract:
Otitis media is a commonly acquired childhood ear condition. Yet the more severe, chronic form of the disease is a major public health problem in low- to middle- income countries and within certain high-risk populations in high-income settings, despite it being largely preventable. Although a high prevalence of the disease is estimated amongst populations within some Pacific Island nations, a paucity of accurate, country specific data has contributed to a lack of awareness of the disease and of its long-term impact on human development. Consequently, there has been very slow improvement of health system infrastructure to adequately address otitis media, even though there is a high apparent need. As part of a larger project to look at the development of hearing services in Pacific Island nations, this thesis was undertaken to both explore the potential for an otitis media programme in The Republic of Fiji and to understand the factors that would facilitate and constrain the development of such a programme. To do so, two methods of data inquiry were utilised. A systematic review was conducted to understand the elements of an effective programme to ameliorate the consequences of otitis media. The study also employed qualitative research methodologies, in the form of key informant interviews, to contribute to a better contextual understanding of the potential for an otitis media programme in Fiji. The results of the study confirm that there is potential for the development and implementation of a more comprehensive otitis media programme in Fiji. Despite significant challenges in service provision and resource availability, a sustainable programme is feasible, but will require long-term commitment, and close collaboration, between intersectoral partners. Any intervention will need to be structured as part of a broader public health programme and be integrated into the local health and social system, alongside adequate provision for funding and support for human resources. The results of the study will provide a valuable tool to inform the planning and development of ear and hearing health services in the Pacific region.