@article{102912,
  keywords = {Noma, Maxillofacial Diseases, Integrated care, Prevention, Early Casefinding, Reconstructive surgery, Health System Strengthening, postoperative follow-up, Oral Health, Child health, Surgical mentorship},
  author = {C N and Mampindu M B and L M and C B and C G and Acosta C N and S K and D S},
  title = {Prevention and Integrated Management of Noma and Maxillofacial Diseases in Burkina Faso, Mali, Madagascar and Togo (2018 – 2028) – Lessons Learnt and Challenges – Preliminary Results},
  abstract = {<jats:p>Noma is a rapidly progressive, preventable orofacial gangrene affecting malnourished children in low-resource settings. La Chaîne de l’Espoir has
implemented a multi-country programme on Noma and maxillofacial conditions (PMF) in three phases: 2018–2021 (phase 1), 2021–2024 (phase 2) in
Burkina Faso and Mali, and 2025–2028 (phase 3) expanding to Togo and Madagascar. We synthesise phase-2 implementation (2021–2024) and report the
2024 mixedmethods endline evaluation.
Quantitative surveys included 454 respondents (227 patients; 227 caregivers). Qualitative enquiry comprised 162 interviews/focus groups with health
workers, community relays, traditional healers, civil-society partners and officials. Quantitative data were analysed in IBM SPSS Statistics; qualitative data
underwent thematic analysis.
The programme trained 659 community relays (219.7% of a 300person target), 613 health workers and 483 community health agents, and supported surgical
care with postoperative follow-up. Knowledge increased by 38% among health workers and 35.5% among traditional healers. Overall, 87.2% of patients
reported improved health and 72.2% of respondents reported increased awareness of Noma and maxillofacial conditions. Stakeholders described reduced
stigma and stronger collaboration between traditional and biomedical providers. Key gaps included patient traceability and continuity of follow-up. In Mali,
loss of funding in 2022 halted reconstructive surgery.
An integrated, communityanchored model linking prevention and awareness, early case-finding, and surgical care delivered meaningful health and system
gains. Priorities are to standardise registries and longitudinal outcome tracking, secure multi-year financing (including for complex reconstruction),
strengthen mentorship and decentralised skills, and restore interrupted services to sustain equitable, timely care.</jats:p>},
  year = {2025},
  journal = {Open Access Journal of Clinical Pathology Research},
  pages = {1-7},
  publisher = {OASK Publishers},
  url = {https://oaskpublishers.com/assets/article-pdf/prevention-and-integrated-management-of-noma-and-maxillofacial-diseases-in-burkina-faso-mali-madagascar-and-togo-2018-2028-lessons-learnt-and-challenges-preliminary-results.pdf},
  doi = {10.61440/oajcpr.2025.v1.13},
  language = {ENG},
}