The series of modules presented here are intended for use by all stakeholders working on TB—national TB control programmes (NTPs), technical partners, non-governmental organizations (NGOs) including community-based groups, and others implementing activities aimed at reaching people with TB who are currently missed by routine health systems. Approaches, activities and recommendations provided in the modules are not a prescriptive process or guidance, rather they are meant as sharing of best practice, learnings from different countries and settings, and examples of what has worked and what has not, in the areas of TB case finding and TB programme strengthening. It is precisely in the area of designing and implementing interventions where partners often need support. The interactive modules provide examples, discussions and deliberations and aim at shifting approaches from business as usual to approaches that can help countries achieve desired results.

This series consists of 10 modules on different interventions and approaches to support improvements in TB case detection and notification. It is divided into modules that align with the areas where people with TB are missed most:

1. Access to care:
   1. Module 1: TB case finding with key populations
   2. Module 2: Strategies for TB case finding in prisons and closed settings
   3. Module 3: Engaging communities to improve TB case finding

2. Within service delivery:
   1. Module 4: Intensified case finding at facility level
   2. Module 5: Scaling up interventions to find children with TB
   3. Module 6: Using contact investigation to find the missing people with TB
   4. Module 7: The role of laboratory systems in TB case detection
   5. Module 8: Chest X-ray screening in TB case detection

3. Through inadequate linkages to care:
   1. Module 9: Finding missing people with TB by engaging the private sector
   2. Module 10: Strengthening informational systems and linkages to care

Each module provides a discussion of why a certain approach would be useful in a particular setting and discusses what to expect from each type of intervention. Different ways to design the interventions are presented and considerations for programme management, as well as monitoring and evaluation are also discussed.

The 10 modules presented here are:

1. TB case finding with key populations: This module presents approaches to TB case finding with key populations. To reach the missing millions, human rights and gender barriers to TB care must be addressed. This module discusses the steps implementers can make in eliminating these barriers through programme design and additional advocacy. Considerations for effective case finding interventions with TB key populations are presented that include examples and must-have options for programming. The module also discusses key population specific M&E indicators.
2. Strategies for TB case finding in prisons and closed settings: Working in prison and closed settings to find missing people with TB has its specific challenges and limitations, but interventions can be successfully implemented, making an important impact on public health outcomes in communities and even entire nations. This module discusses the stakeholders needed and the approaches to launch case finding in prisons as well as details a number of experiences and practical lessons that can assist in designing and implementing effective TB services in prisons.
3. Engaging communities to improve TB case finding: This module presents approaches to case finding in the community. Departing from a facility-based and other passive case finding approaches, community case finding is generally more complex and resource-intensive. At the same time, community-level buy-in and well-managed collaborations may guarantee access to TB services for previously unreached communities and impact in the long term. This module is central to the work of Stop TB Partnership and TB REACH and serves as a basis for planning community-based interventions. The module discusses the steps needed to effectively work with communities, engage all relevant stakeholders, utilize existing resources, and devise approaches to case-finding that align with community needs. An M&E section and a list of resources are also presented.
4. Intensified case finding at facility level: Public health facilities are crucial partners in implementing programmes that aim to find missing people with TB. While facility-based approaches have been the traditional focus of the TB response, numerous studies have shown many people are missed even when presenting to health facilities. This module describes the key steps for designing and launching a more intensive interventions within facilities and presents examples of engaging with various types of providers.
5. Scaling up interventions to find children with TB: Childhood TB presents a unique challenge in terms of diagnosis and treatment provision. This module aims to support implementers in rolling out and contributing to effective interventions to find missing children with TB. The module addresses the need for education of caretakers and providers, discusses decision making involved in diagnosis, and highlights the importance of treating TB infection.
6. Using contact investigation to find the missing people with TB: Contact investigation is a cornerstone of TB control. While there is much guidance, training and detailed implementation instructions on rolling out contact investigation programming, this module adds rationale, summarizes recent practice, and discusses ways to effectively organize and design contact investigation activities.
7. The role of laboratory systems in TB case detection: Laboratories and laboratory networks are a crucial part of scaling up TB case detection but are often forgotten during planning of other case finding activities. This module aims to support implementers in making informed decisions around the needed expansion of laboratory services within the framework of interventions aimed at finding missing people with TB.
8. Chest X-ray screening in TB case detection: When used effectively, chest X-ray can aide diagnosis, streamline programming and help identify people who would otherwise remain unreached by TB case finding programs. This module discusses what implementers can expect from utilizing chest X-ray for screening and how to make the best use out of X-ray technologies to improve case detection.
9. Finding missing people with TB by engaging the private sector: In many settings, non-public sector providers have a broad reach and can make a significant contribution to TB care and prevention. While the traditional approaches in private provider engagement have focused on public sector-controlled strategies, this module discusses many newer models, the types of providers to engage and elaborates on successes and challenges of working in the private sector.
10. Strengthening informational systems and linkages to care: While many people are missed due to insufficient case finding activities, others are lost in recording and reporting systems that are not equipped to adequately track lab results, notifications and treatment outcomes. These systems are crucial to ensuring that people with TB receive the continuum of care that they need and for providing national TB programmes with data for course correction. This module discusses what implementers need to consider in setting up such systems, technologies already available and gives further recommendations for system design.