There is a need for evidence-based programmes that address nutritional, health, and behavioural factors that impact children with severe acute malnutrition (SAM). In critical cases, hospital treatment is required for children with SAM but post discharge outcomes remain poor. We believe that the time spent in-hospital while children receive treatment for SAM is a valuable opportunity to provide programs for primary caregivers (mainly mothers) to target underlying causes and consequences of SAM. Therefore, we have designed a comprehensive hospital-based structured intervention package that will be evaluated at the Moyo Nutrition Rehabilitation & Research Unit of the Queen Elizabeth Central Hospital in Malawi. The four-day intervention program for primary caregivers of children with SAM will be nurse led and consists of multiple modules: 1) nutrition; 2) water, sanitation and hygiene; 3) and psychosocial stimulation (e.g. play activities). This randomized trial will assess the developmental and nutritional outcomes of this intervention package for primary caregivers of children 6-59 months of age hospitalized with SAM. Results from this trial will have the potential to instigate the appraisal of guidelines for hospital treatment of SAM to improve growth and development in these children.