Title: Exploring service delivery gaps in childhood otitis media: A focus on Màori and pacific tamariki (children) in Aotearoa
Abstract:
Introduction: Otitis media, commonly referred to as "glue ear," is a condition characterised by the presence of fluid in the middle ear, which can manifest in two primary forms. Acute otitis media (AOM) occurs when the fluid buildup is associated with symptoms of acute illness, such as ear pain, fever, upper respiratory tract infection, tinnitus, or vertigo (Auckland Regional Community Pathways, 2025). In contrast, otitis media with effusion (OME) is the presence of fluid in the middle ear without evidence of acute inflammation (Auckland Regional Community Pathways, 2025). Otitis media is a major global health issue, which affects approximately 250 million people and disproportionately affects socioeconomically disadvantaged populations (Bhutta, Leach & Brennan-Jones, 2024). In New Zealand, studies suggest that up to 80% of children experience at least one episode of Otitis media effusion by age 10 years old, and the duration is approximately 6 to 10 weeks (Auckland Regional Community Pathways, 2025). If left untreated, otitis media can lead to temporary or permanent hearing loss, adversely affecting a child’s ability to learn, communicate, and engage socially. Surgical treatment of recurrent Otitis media effusion diagnosis is by ventilation tubes for children aged 0 to 4 years in Aotearoa (New Zealand). Large ethnic disparities exist in accessing ventilation tubes for children aged 0 to 4 years in New Zealand, with the greatest inequalities seen in Màori and Pacific children living in the most deprived areas (Te Whatu Ora, 2024). This research aims to identify gaps in service delivery for childhood ear health, specifically Otitis Media, particularly for Màori and Pacific Tamariki (children), to enhance screening initiatives, accessibility, and timely intervention strategies.
Method: The methodology conducted was content analysis using Creswell’s (2009) framework for qualitative data analysis. A step-by-step approach was undertaken to review the data. The data review included Practitioner's handbooks, research articles, and national reports were analysed to gain insight and understanding of the gaps within service delivery. Detailed analysis and coding were systematically coded to identify recurring trends, patterns, and key text. Interpretation of emerging themes was identified, and findings were interpreted to derive meaning from the data collection key themes.
Findings
Earlier Detection: Timely identification and management of early childhood ear disease and hearing loss are essential to mitigate long-term impacts, such as developmental delays, educational challenges, and behavioural issues.
Need for More Equitable Hearing Health: Ethnic and socio-economic disparities in access to care are significant, particularly for Màori and Pacific Tamariki living in deprivation. Addressing these inequities is vital to meeting the community's high-risk Tamariki needs.
Improved Responsiveness is Needed: There is a need for better responsiveness in healthcare systems, including improving attendance rates at Ear Nose and Throat outpatient clinics and removing barriers such as cost, transport, and time off work for families. Research into these systemic barriers is essential for more effective intervention.
