 Tuberculosis treatment registers were translated into the local language and were modified to fit with the monitoring and interpretation of treatment outcomes at health facility level for patients in the three treatment groups. Volunteer CHWs were also trained by their nearby health institution TB focal person on patient care, drug handling, indications for referral, managing side effects, and the use of the patient adherence card. Quarterly supervisory support was given by regional experts to district health offices, while health institutions were supervised on a monthly basis by district TB coordinators. The nearby TB focal person provided technical support to volunteer CHWs during their monthly meeting in the respective health facilities. Biannual evaluation between district health staff with HQ staff and district health staff with TB focal persons were instituted. The implementation of the above measures prior to the launching of the trial created operational conditions of components of the strategy as recommended by the NTC and International Union against Tuberculosis and Lung disease IUTLWHO Wold Health Organisatio guidelines. Strengthening the health system based on local conditions is assumed to be a basis for determining specific needs, and for creating the conditions for the development of the necessary managerial and technical skills for effective implementation of a community-based TB care. 