03072nas a2200337 4500000000100000008004100001260002000042653000900062653002700071653002000098653001500118653002200133653002700155653003200182653002800214653001600242653001700258653002400275100000800299700001700307700000800324700000800332700000800340700001500348700000800363700000800371245019300379856022700572300000800799520192700807 2025 d bOASK Publishers10aNoma10aMaxillofacial Diseases10aIntegrated care10aPrevention10aEarly Casefinding10aReconstructive surgery10aHealth System Strengthening10apostoperative follow-up10aOral Health10aChild health10aSurgical mentorship1 aC N1 aMampindu M B1 aL M1 aC B1 aC G1 aAcosta C N1 aS K1 aD S00aPrevention and Integrated Management of Noma and Maxillofacial Diseases in Burkina Faso, Mali, Madagascar and Togo (2018 – 2028) – Lessons Learnt and Challenges – Preliminary Results uhttps://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 a1-73 aNoma 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.