"Introduction: Otitis media (OM) is a commonly acquired childhood ear condition. Yet if undetected and untreated, the more severe, chronic form of OM can develop and result in a number of serious medical complications, including permanent hearing loss. While there is an estimated high prevalence of chronic OM and OM related hearing loss in the Pacific region (1-4) and Fiji (5-6), there remains a lack of reliable population-based data and few and scattered services to address the condition. The research was undertaken to explore whether an OM programme in Fiji is needed and what elements would constitute an effective programme. Method: The two methods of data inquiry were: 1. Systematic review: to understand the elements of an effective OM programme. 2. Key informant interviews: to examine the feasibility of an OM programme in Fiji. Results: There are a number of key elements that constitute an effective OM programme including: clear identification of the problem through intersectoral collaboration; reliable country-based data; integration of the intervention within the local health and social system; and adequate resources and research to ensure long-term sustainability and efficacy. Discussion: Despite significant challenges in service provisional and resource availability, a sustainable OM programme is indicated and feasible, but is contingent on a number of critical factors. A broad public health is critical to address this complex condition. This study provides preliminary background work for future research in this area. Key Words: Child Health, Chronic disease management and prevention, healthy islands, Three key messages: 1. With an estimated high prevalence of OM, but very scattered services, a more developed OM programme/intervention is indicated in Fiji, however it is highly dependent on a number of critical factors to ensure sustainability and efficacy. 2. Reliable country-based data, close collaboration with intersectoral partners, adequate provision for funding and support for human resources are critical factors. 3. The complex nature of OM means that an intersectoral, public health approach to addressing the issue is indicated. "