Malaria in Ethiopia is one of the leading causes of death (21.8 percent), consultation in outpatient departments (17.8 percent) and hospital admissions (14.1 percent) (2;14). To overcome this problem, the Malaria Control Program (Federal Ministry of Health) has designed a communitybased malaria treatment approach that played key roles in malaria epidemic control and community mobilization as well as vector control operations. In this approach, Community Health Workers (CHWs) and Village Malaria Workers, volunteers selected by community and trained on malaria diagnosis and treatment as well as indoor residual spray for few days (16). However, sustainability of this approach has been a challenge to the malaria control program. Thus, institutional arrangements in which every Kebele (the smallest administrative unit of 5,000 people) has a health post staffed by two Health Extension Workers (HEW) as part of the country’s health system is a breakthrough to strengthen malaria control. A study has shown that more than half of the patients with fever visit CHWs and private health facility services (4). In Ethiopia, unlike in many parts of Africa, Plasmodium vivax accounts for 30–40 percent of the confirmed malaria cases reported annually (8;14;17). This makes confirmation of cases crucial to render appropriate and effective malaria treatment at health facilities, including health posts.