Recovery Rate of Under‐Five Children From Severe Acute Malnutrition and Its Predictors in Ethiopia: A Systematic Review and Meta‐Analysis

Background: Previous reviews on severe acute malnutrition recovery in Ethiopia were limited by outdated data and narrow scope. This study used recent and regionally diverse data, including from conflict-affected areas, to inform current nutrition efforts. Objective: To provide up-to-date information on the recovery rate of Children under five from severe acute malnutrition in Ethiopia. Methods: A systematic review and meta-analysis of observational studies published between January 2015 and July 2025 was conducted. PubMed, Scopus, Web of Science, Google Scholar, and African Journals Online were searched. The pooled prevalence was estimated using random-effects model with 95% confidence intervals. Publication bias was assessed using funnel plots and Egger's test. Results: The pooled recovery rate of under-five children from severe acute malnutrition was 71.37% (95% CI: 67.57-75.16%). Anemia (AHR = 0.75, 95% CI: 0.63-0.87), shock (AHR = 0.52, 95% CI: 0.13-0.92), HIV/AIDS (AHR = 0.71, 95% CI: 0.44-0.97), use of a nasogastric tube (AHR = 0.62, 95% CI: 0.31-0.93), vomiting (AHR = 0.65, 95% CI: 0.43-0.86), diarrhea (AHR = 0.71, 95% CI: 0.56-0.86), tuberculosis (AHR = 0.47, 95% CI: 0.34-0.60), and pneumonia (AHR = 0.73, 95% CI: 0.61-0.84) were associated with decreased recovery rate. Conversely, the use of amoxicillin (AHR = 2.10, 95% CI: 1.54-2.70), vitamin A supplementation (AHR = 1.50, 95% CI: 1.21-1.79), absence of malaria (AHR = 1.51, 95% CI: 1.03-1.98), deworming (AHR = 1.45, 95% CI: 1.04-1.82), and provision of ready-to-use therapeutic food (AHR = 1.63, 95% CI: 1.07-2.20) were associated with improved recovery rate. Conclusion: The recovery rate of under-five children from severe acute malnutrition in Ethiopia remained below national and international targets. Strengthening early detection and management of symptoms and comorbidities, along with scaling up proven interventions, is essential to improving recovery rate.