Tuberculosis (TB) remains a significant public health challenge in Nigerian northern cities, necessitating robust healthcare delivery systems for prevention and treatment. A mixed-methods approach combining qualitative interviews with quantitative data analysis was employed to assess system effectiveness over a five-year period. Community engagement significantly improved adherence rates (85%) compared to control groups, demonstrating the value of active community participation in TB management. The study highlights the efficacy of tailored healthcare delivery models and underscores the importance of ongoing community involvement for sustained TB prevention and treatment success. Policy makers should prioritise investment in community-based healthcare infrastructure and promote robust partnership frameworks with local communities. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.