Urban Gambian slums face significant health challenges, particularly concerning TB diagnosis and treatment. The prevalence of TB is high in these areas, necessitating effective training programmes for healthcare workers. The study employed structured training modules delivered by local healthcare providers. Training covered TB diagnostics, management protocols, and infection control measures. Data collection included pre- and post-training assessments to evaluate knowledge gains and practice improvements among participants. Participants demonstrated a statistically significant improvement in identifying smear-positive TB cases (p < 0.05) after training, with an increase of 20% in correct identification rates compared to baseline. The health worker training programme significantly enhanced TB diagnosis skills and adherence to treatment protocols among urban Gambian slum residents. Further implementation should include continuous education sessions and community engagement initiatives to reinforce learning outcomes. TB Diagnosis, Urban Slums, Health Worker Training, One-Year Implementation Evaluation Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.