Our research questions is "Among primary care services in the Northern Territory, does employment, clinical training and integration of local Ear Health Facilitators (EHFs) into health and education services (the Hearing for Learning initiative), compared to current practice, reduce the prevalence of OM and untreated hearing loss in Aboriginal and Torres Strait Islander children during a three year trial period?" A proposed Activity Work Plan is based on implementing the Initiative in 20 communities over a 4 year period (2 in 2019, 6 more in 2020, 8 more in 2021, then the final 4 in 2022), training and employing 40 Ear Health Facilitaors (EHFs), and servicing 5000 children 0 to 16 years of age, with a focus on pre-school children. Research outcomes will include a mixed methods approach to evaluate the workforce development and integration aspects, analysis of pre-Initiative data obtained from services via data sharing agreements, analysis of baseline burden of disease obtained by the Initiative's surveillance, change in burden of disease (prevalence) and clinical outcomes (by disease category) during the Initiative's activity, compared to pre Initiative.