Evaluation of inpatient stabilization centers and outpatient therapeutic programmes for severe acute malnutrition management in El-Gadarif State, Sudan

El-Gadarif State, eastern Sudan, hosts over 2.4 million residents alongside large refugee and internally displaced populations across 12 localities. Severe seasonal flooding continuously disrupts sanitation infrastructure and restricts access to healthcare. This study evaluated the clinical performance, admission distribution, and treatment outcomes of inpatient Stabilization Centers (SCs) and Outpatient Therapeutic Programmes (OTPs) against international sphere standards. A secondary data analysis was conducted on August 2026 ministry of health routine surveillance records. Standardized programmatic metrics were cleaned, aggregated, and analyzed using python (pandas, seaborn, matplotlib). Data audits were integrated to assess facility-level registry accuracy and regional health information governance. Inpatient SCs admitted 295 children with complicated Severe Acute Malnutrition (SAM) (53.9% boys, 46.1% girls). Inpatient performance exceeded the >75.0% sphere cure benchmark, achieving an 83.7% cure rate (n=247), zero mortality, and zero dropouts. Additionally, 3.4% (n=10) were transferred to OTP care, and 12.9% (n=38) remained in treatment. Three facilities managed 58.0% of all inpatient cases: Al Gedaref-SC (n=81), Tenadba MSF Refugee Camp SC (n=55), and Um Rakouba MSF Refugee Camp SC (n=35). Registry audits identified administrative record errors, including missing placeholders and duplicate facility identifiers. Outpatient OTPs enrolled 2,903 uncomplicated SAM cases, yielding an overall 95.0% cure rate, 4.0% default rate, and 1.0% non-response rate. While central localities such as Gala Anahal and Elbotana achieved complete treatment success (100.0% cure rate; 0.0% default), high default rates occurred in Alfashaga (26.0% default; 72.0% cure) and West Galabat (15.0% default; 85.0% cure). SAM management in El-Gadarif State demonstrated high clinical efficacy meeting sphere benchmarks. However, operational priorities must focus on reducing default rates in border localities and standardizing facility-level digital data quality protocols.

Mohamed Mahmoud Talib is a public health epidemiologist, informaticist, and Africa CDC public health informatics fellow stationed at the Zambia National Public Health Institute. With extensive experience in humanitarian emergency response, health data governance, and disease surveillance across Sudan and East/Southern Africa, his work focuses on leveraging digital health analytics to strengthen surveillance systems and improve health outcomes in crisis-affected regions. He holds advanced qualifications in public health, epidemiology, and applied data science.