 The decentralization of TB care at community level using the existing volunteer CHWs program was anticipated to be a feasible option to institute most of the components of the WHO-recommended DOTS strategy. Volunteer CHWs can be trained in patient care on a continuous basis. Accountability on anti-TB drugs used and reporting on treatment outcomes can be obtained using the existing link between CHWs and nearby public health facilities. The services they render are appreciated by respective communities. The self-administered treatment option was considered after critical examination of previous effectiveness studies, patients convenience to tuberculosis care and, most importantly, taking into account the views expressed by communities and patients. Operational challenges, in which health workers could be forced to allow patients to take treatment by themselves when there are no volunteer CHWs who could offer TB care in remote areas was also considered. 