Prevention and Integrated Management of Noma and Maxillofacial Diseases in Burkina Faso, Mali, Madagascar and Togo (2018 – 2028) – Lessons Learnt and Challenges – Preliminary Results
Year: 2025
Type: article
Abstract: 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.
Authors: Multi-Country Programme Coordinator, Nicolas C, Bunkembo Mampindu M, Head of Mission, Martin L, Africa Region Health Focal Point, Basimage C, Head of Mission Burkina Faso, Gonter C, Noguera Acosta C, Head of Mission Madagascar, Kouadio S, Head of Mission Togo, Sobrero D
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4414515781
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