IMID training and OSS combined was associated with improvements in six indicators : three ETAT indicators ( outpatients triaged ( aRR = 2.03 , 99 % CI = 1.13,3.64 ) , emergency and priority patients admitted , detained or referred ( aRR = 3.03 , 99 % CI = 1.40,6.56 ) , and emergency patients receiving at least one appropriate treatment ( aRR = 1.77 , 99 % CI = 1.10,2.84 ) ) ; two malaria indicators ( malaria cases receiving appropriate antimalarial ( aRR = 1.50 , 99 % CI = 1.04,2.17 ) , and patients with negative malaria test results prescribed antimalarial ( aRR = 0.67 , 99 % CI = 0.46,0.97 ) ) ; and enrollment in HIV care ( aRR = 1.58 , 99 % CI = 1.32,1.89 ) .