 2. Operational factors The intervention was designed to be implemented under operational conditions of the district health system and the ongoing community-based volunteer CHW programme. CHWs get technical and material support form nearby health facilities. They are required to submit their activity report at these facilities on a monthly basis. This arrangement has been found effective in maintaining the functionality of CHWs while minimizing disruptions in their daily life. Given this operational condition, patients have to be managed in nearby health facilities for the first four weeks until proper selection and introduction with respective CHWs are made. Other operational factors in favour of this arrangement include its feasibility when scaling up the intervention, low time cost of CHWs and the health system. This operational set up was anticipated to enable TB focal persons to organize a monthly evaluation session with CHWs in their catchments. 