RESUMO
INTRODUCTION: The Integrated Family Health Program supported the government of Ethiopia to implement the Integrated Community Case Management (iCCM) strategy to control childhood illness of which malaria is a major cause. OBJECTIVE: To assess the effect of ICCM training on quality of malaria case management at health posts. METHODS: . A comparative cross-sectional study was conducted among 170 Health Extension Workers (HEW) providing either integrated or vertical malaria case management for children less than five years of age in 14 woredas (districts) of West Hararghe Zone using a multi-stage sampling procedure. HEWs in seven intervention woredas were trained in malaria case management and rapid diagnostic test (RDT) procedures through iCCM, and HEWs in comparison woredas were trained vertically through the national malaria control program. Performance was assessed using interview, review of registers, and observation of RDT procedure. RESULTS: Intervention HEWs performed better than their counterparts in correct drug prescription (90.8 vs. 81.0%, p = 0.03), treatment duration (97.7 vs. 89.9%, p = 0.001), and treatment schedule (95.4 vs. 75.9%, p = 0.000). Intervention HEWs recorded case management with more consistency than their counterparts (≥ 80% consistency between: classification and assessment [23.0 vs. 3.8%; p = 0.000], classification and treatment [24.1 vs. 7.6%; p = 0.003], and classification and follow up [24.1% vs. 0.0%; p = 0.000]); however, there is room for improvement. CONCLUSION: ICCM training has a positive effect on the quality of malaria case management at the community level.