Outcomes of severe acute malnutrition management in therapeutic feeding centres: a retrospective records study in Yemen (2025)

Severe acute malnutrition (SAM) remains a major public health concern in countries affected by humanitarian crises, particularly in conflict settings. Therapeutic Feeding Centres (TFCs) play a crucial role in the management of children with complicated SAM. This study assessed treatment outcomes and key performance indicators — including recovery, mortality, and default rates — across TFCs in Yemen in order to identify potential areas for programme improvement. A retrospective secondary analysis was conducted using anonymized routine programme data from TFCs in the ten governorates under the internationally recognised Government of Yemen. Aggregate performance indicators were first analysed across all governorates. Aden was selected as it is the capital and the most populous included governorate; a descriptive comparison of its two TFCs was subsequently performed. RESULTS: Mean recovery (97.10%), mortality (0.67%) and default (2.23%) rates across the governorates were generally within the Sphere recommended standards. However, the aggregate data for Aden governorate were the lowest (92.27%, 1.25%, 6.48%). Within Aden, the PHC-based TFC (recovery rate = 98.25%, mortality rate = 0.22%, default rate = 1.53%) showed better programme indicators than the hospital-based TFC (recovery rate = 86.07%, mortality rate = 2.70%, default rate = 11.23%). The PHC-based facility also demonstrated a more even distribution of admissions throughout the year. However, as this comparison was limited to two facilities, the observed differences may also reflect unmeasured contextual and organisational factors. CONCLUSIONS: Findings suggest that the organization and context of TFC service delivery may be associated with differences in programme performance in humanitarian settings. Results should be interpreted with caution because of the limited sample and observational design. Larger multicentre studies are needed to determine whether specific service delivery models are associated with improved treatment outcomes and to inform national nutrition policies in conflict-affected settings.