 Baseline studies were conducted to determine the quality of TB diagnosis, patient care and treatment outcome and to identify alternative options TB care appropriate to local conditions. Six months prior to the trial, the limitations of the ongoing DOTS found by these studies were communicated to district health office heads, hospital directors and district TB experts in order to strengthen the quality of TB care and management of district TB programs. Specific tools that were not developed by the National Tuberculosis Program NTC to ensure consistent application of diagnostic criteria, patient counsellinghealth information, standards on supervisory support, drug supply and district evaluation were prepared in consultation with district health management experts and hospital directors. Subsequently, district TB coordinators, health institution-based TB focal persons and clinicians were trained on patient diagnosis, patient care, community-based tuberculosis care and the study protocol. Based on our baseline assessment of quality of care, the following measures which improve patient-centred care were instituted at health facility level: 