Pretreatment loss to follow-up (PTLTFU) is a major problem in DR-TB care in Nigeria. In 2020, only 10% of estimated 21,000 MDR-TB cases were notified with 38% PTLTFU. PTLTFU is 46% in the two project states. This proposal aims to reduce the gap to 10% by decentralizing the care pathway to improve access, reduce refusal rates and improve turnaround time of baseline tests using digital technology.