Severe acute malnutrition remains crucial in South Kivu in general and in the Bagira health zone in particular. Severe emaciation affects 7.8% of South Kivu children against 10% for the entire DRC. In 2012 the Bagira health zone, experts found that the prevalence of severe acute malnutrition would be 2.4% and global acute malnutrition of 6.1% against 7.8% for the entire province. The overall objective of this study is to contribute to improving the management of severe acute malnutrition in Bagira health zone. This is an assessment of the current level of implementation support for severe acute malnutrition protocol. This cohort study has allowed us to study the evolution of anthropometric parameters children admitted to the output of the UNTI and output to 6 months. Subsequently we studied the risk factors for death among the discharged malnourished child and have experienced the breakdown of inputs. We found that changes in the weight-for-height z-score for most children was slow (<- 3SD) and the height gain in three months out of the UNTI for children who have experienced more than 30 days failure (P=0.005). Influenced the deaths of children in the community are anemia (P = 0.03), infection represented by fever (P = 0.03), the level of education of mothers (P = 0.03) the profession of the mothers (P = 0.03), non-worming (P=0.02) and the status of the mother (P=0.03). The fight against severe acute malnutrition implies the availability of inputs and preventative measures to ensure good survival for children ZS Bagira.