BACKGROUND: Outpatient Therapeutic feeding Program (OTP) brings the services for 
management of Severe Acute Malnutrition (SAM) closer to the community by making 
services available at decentralized treatment points within the primary health 
care settings, through the use of ready-to-use therapeutic foods, community 
outreach and mobilization. Little is known about the program outcomes. This 
study revealed the levels of program outcome indictors and determinant factors 
to recovery rate.
METHODS: A retrospective cohort study was conducted on 628 children who had been 
managed for SAM under OTP from April/2008 to January/2012. The children were 
selected using systematic random sampling from 12 health posts and 4 health 
centers. The study relied on information of demographic characteristics, 
anthropometries, Plumpy'Nut, medical problems and routine medications intakes. 
The results were estimated using Kaplan-Meier survival curves, log-rank test and 
Cox-regression.
RESULTS: The recovery, defaulter, mortality and weight gain rates were 61.78%, 
13.85%, 3.02% and 5.23 gm/kg/day, respectively. Routine medications were 
administered partially and children with medical problems were managed 
inappropriately under the program. As a child consumed one more sachet of 
Plumpy'Nut, the recovery rate from SAM increased by 4% (HR = 1.04, 
95%-CI = 1.03, 1.05, P<0.001). The adjusted hazard ratios to recovery of 
children with diarrhea, appetite loss with Plumpy'Nut and failure to gain weight 
were 2.20 (HR = 2.20, 95%-CI = 1.31, 3.41, P = 0.001), 4.49 (HR = 1.74, 
95%-CI = 1.07, 2.83, P = 0.046) and 3.88 (HR = 1.95, 95%-CI = 1.17, 3.23, 
P<0.001), respectively. Children who took amoxicillin and de-worming had 95% 
(HR = 1.95, 95%-CI = 1.17, 3.23) and 74% (HR = 1.74, 95%-CI = 1.07, 2.83) more 
probability to recover from SAM as compared to those who didn't take them.
CONCLUSIONS: The OTP was partially successful. Management of children with 
comorbidities under the program and partial administration of routine drugs were 
major threats for the program effectiveness. The stakeholders should focus on 
creating the capacity of the OTP providers on proper management of SAM to 
achieve fully effective program.