<p>&nbsp;Healthcare providers’<strong> </strong>adherence to the national malarial case management guideline was below the standard both in public and private health facilities in Afar region, Ethiopia due to various factors identified in this study.&nbsp; By improving guideline adherence we can decrease morbidity and mortality related to malaria cases. Facility supervision, training, ensuring access and delivery of malaria case management guidelines and job aides would increase the adherence to malaria case management guidelines.&nbsp;</p>