3. Suggestive Plan for Training (ULB Level)
Category Venue
Trainer
(Trained in
State/District TOT)
Timeline
H-to-H Survey Workers &
Supervisors (Urban)
ULB in batches
ULB TOT trained
persons, Health Officer,
ACMOH, Nodal Officer
(Health Dept), Dist. Prog
Officers, Consultants
trained in State TOT
April/May
Vector Control Teams (Urban) ULB in batches
SI, Dist. TOT trained
persons, Consultants
trained in State TOT
4th week
of April
Councilors & Citizens' Task Forces ULB in batches
ULB persons trained in
Dist. TOT
June
PRI Members, Office Bearers &
Citizens’ Task Forces
Gram Panchayet
GP persons trained in
Dist. TOT
June
Youth Club members ULB/GP in batches
ULB persons trained in
Dist. TOT, GP persons
trained in Dist. TOT
June
4. Progress Report of Training on Prevention & Mangement of Dengue,2019
District : Darjeeling
Name of ULB :
Month :April
Category Venue
Trainer
(Trained in
State/District
TOT)
Batch Size &
Duration
(mentioned in
action plan)
Timeline
Total no of
Trainees to
be trained
No. of
Batches
Date of
Commence
ment
No. of
Participants
trained
Absentees
(If,any)
Remarks, (If
any)
H-to-H Survey
Workers &
Supervisors
(Urban)
ULB in
batches
ULB TOT trained
persons, Health
Officer, ACMOH,
Nodal Officer
(Health Dept),
Dist. Prog
Officers,
Consultants
trained in State
TOT
40-60; half day April/May
Vector Control
Teams (Urban)
ULB in
batches
SI, Dist. TOT
trained persons,
Consultants
trained in State
TOT
40-60; half day
4th week of
April
Councilors &
Citizens' Task
Forces
ULB in
batches
ULB persons
trained in Dist.
TOT
40-60 ; half day June
Youth Club
members
ULB/GP
in
batches
ULB persons
trained in Dist.
TOT, GP persons
trained in Dist.
TOT
40-60; half day June
6. Composition & roles of H-to-H Survey Team
(Urban)
• 2 member Team, comprising of HHW/ MAS Member/ SHG
Member/ Volunteer.
• Visits 60 households (avg) per day - 300 hh in a Round.
• 5-day Rounds every fortnight – to cover all households.
• H-to-H Survey Teams visit households, areas between houses,
vacant spaces and public places as well.
• They do 4 things:
- Collection of fever data (fever surveillance).
- Search for mosquito breeding spots and presence of
mosquito larvae.
- Listing of environmental risk sites.
- IPC on dengue and community involvement.
• Day-wise Team-wise microplan, with start house & end house,
to be in place in Form-1.
7. Composition & roles of H-to-H Survey Team
(Rural)
• Four 2 Member Team, comprising of VRPs/ Volunteer per
Gram Panchayet.
• Two 3 Member Vector Control Team per Gram Panchayet.
• One Supervisor and one data entry person per Gram
Panchayet.
• 5-day Rounds every week – to cover all households.
• H-to-H Survey Teams visit households, areas between houses,
vacant spaces and public places as well.
• They do 4 things:
- Collection of fever data (fever surveillance).
- Search for mosquito breeding spots and presence of
mosquito larvae.
- Listing of environmental risk sites.
- IPC on dengue and community involvement.
• Day-wise Team-wise microplan to be made ready.
8. Reporting by H-to-H Survey Teams (Urban)
• 1 Supervisor per 5 H-to-H Survey Teams.
• Daily visit of Survey Teams as per microplan and reporting to
Supervisor in 2 forms.
(i) Form-2:
- No. of persons suffering from fever on the day.
- No. of containers & drains checked and no. where
mosquito larvae found.
- No. of containers managed during the visit.
- List of environmental risk sites.
(ii) Form-3:
- List of locations where larvae found. (Priority points for
Vector Control Team).
9. Reporting by H-to-H Survey Teams (Rural)
• Daily visit of Survey Teams as per microplan and reporting to
Supervisor in 2 forms.
(i) Form-A:
- No. of persons suffering from fever on the day.
- No. of containers & drains checked and no. where
mosquito larvae found.
- No. of containers managed during the visit.
- List of environmental risk sites.
(ii) Form-B:
- List of locations where larvae found. (Priority points for
Vector Control Team). Half of the form (items marked
with **)
10. Reporting by Supervisor (Urban)
• Data of Form-2 compiled by Supervisor in Form-4.
• Form-4 taken to UPHC or ULB headquarter, where data are
entered daily into an online portal.
• Locations of environmental risk sites compiled in Form-5.
• Form-3 handed to Vector Control Team (VCT) for priority
action in larva containing sites. VCT completes the rest part.
• Form-5 handed to S.I. for necessary action in risk sites and
sharing it with other Wings of ULB.
• After filling-up of rest part by SI, summary of Form-5 entered
into the portal.
11. Reporting by Supervisor (Rural)
• Data of Form-A compiled by Supervisor in Form-C.
• Form-C taken to GP headquarter, where data are entered daily into
an online portal.
• Form-B handed to Vector Control Team (VCT) for priority action in
potential breeding sites. VCT completes the rest part.
• After filling-up of rest part by VCT, the compiled Form C to be
entered in the portal.
12. Feedback from portal
• Daily feedback goes automatically to designated e-mail
addresses.
• Feedback contains 3 types of information:
- Work done, team-wise & ward-wise
- A few indicators of quality of work
- Entomological & environmental situation.
25. Form 12 (Urban) 1/2
1 2 3 4 5 6 7 8
Low
Land
Permanent Risk Sites in the Municipality (For mandatory follow up through out the year)
Blocked
drain
&
Canal
Remarks
Action taken (date). If action could not be taken, reason thereof
Garbage
remains
piled
up
Sl.
No.
Type Name, Location Ward No.
HTH
Team No.
26. Form 12 (Urban) 2/2
1 2 3 4 5 6 7 8
Action taken (date). If action could not be taken, reason thereof
Remarks
Abandoned
Area
Major
Construction
Sites
Any
Other
Sl.
No.
Type Name, Location Ward No.
HTH
Team No.
31. ULB summary report with alerts
ULB Wise Daily Monitoring Proforma of --All--(--All--) on 26/Sep/2018
Name of
Municipality
Number
of
teams
Number
of
teams
reporte
d
Total
No. of
House
holds
to be
visited
for the
day
Percen
tage of
house
holds
not
visited
No. of
ANY
fever
cases
found
for the
day
No. of
fever
cases
with joint
pain/defi
nite body
ache/vo
miting/lo
ose
motion
Wards
where
cluster of
fever
cases
found
Wards
where
Upsurge Of
Fever With Jt
Pain
Vomiting Etc
% of
house-
holds
where
larvae
found
No. of
teams
exami
ned
contai
ners
less
than 2
/hous
ehold
% of
containers
where larvae
found
Gangarampo
re
48 48 2928 1.95 29 0 0.10 0 0.07
Darjeeling 80 80 4194 0.12 137 10 13,18,32 24,25 0.00 0 0.00
Kurseong 20 20 1301 0.00 10 0 6 0.00 0 0.00
Mirik N.A.A. 9 9 571 0.00 7 0 0.00 0 0.00
Jhargram 57 57 3573 0.00 29 0 3.86 0 2.05
Kalimpong 34 34 1928 0.21 10 0 0.05 0 0.01
Egra 27 27 1648 0.00 38 0 7 0.00 0 0.09
Birnagar 25 25 1404 0.21 7 1 4.78 0 0.86
a. Clusters of fever b. Upsurge of fever with dengue like features
c. Relatively high House Index d. Absolutely ‘0’ House Index ! – Poor performance?
32. High container index in parts of Coochbehar M
Ward Wise Daily Proforma of Cooch Behar (Cooch Behar) on 25/Sep/2018
Ward
Total
No. of
House
holds
to be
visited
for the
day
No. of
House
holds
visited
for the
day
Percen
tage of
house
holds
not
visited
No. of
ANY
fever
cases
found
for the
day
No. of
fever
cases
with
joint
pain/de
finite
body
ache/vo
miting/l
oose
motion
Wards
where
cluster of
fever cases
found
Wards where
Upsurge Of
Fever With Jt
Pain Vomiting
Etc
% of households
where larvae
found
No. of
teams
examin
ed
contain
ers less
than 2
/house
hold
% of containers
where larvae
found
12 300 300 0.00 6 0 0.60 0.00 0.00 No 0.70
13 180 180 0.00 5 0 0.75 0.00 0.00 No 6.34
14 180 180 0.00 4 0 0.66 0.00 0.00 No 12.33
15 240 240 0.00 5 0 0.55 0.00 0.00 No 0.39
16 180 180 0.00 4 0 0.51 0.00 0.00 No 0.69
33. Team-wise details of container index, Coochbehar
Team Wise Daily Proforma of Cooch Behar (Cooch Behar) on 25/Sep/2018
Ward Team
Total
No. of
House
holds
to be
visite
d for
the
day
No. of
House
holds
visited
for the
day
Perce
ntage
of
house
holds
not
visite
d
No. of
ANY
fever
cases
found
for the
day
No. of fever
cases with
joint
pain/definit
e body
ache/vomiti
ng/loose
motion
Wards
where
cluster
of
fever
cases
found
Wards
where
Upsurge Of
Fever With Jt
Pain
Vomiting Etc
% of
households
where larvae
found
No. of
teams
examin
ed
contain
ers less
than 2
/house
hold
% of
containers
where larvae
found
13 41 60 60 0.00 2 0 0.88 0.00 0.00 No 10.14
13 42 60 60 0.00 1 0 0.48 0.00 0.00 No 6.99
13 69 60 60 0.00 2 0 0.87 0.00 0.00 No 1.04
14 43 60 60 0.00 1 0 0.45 0.00 0.00 No 7.87
14 44 60 60 0.00 2 0 1.02 0.00 0.00 No 15.38
14 45 60 60 0.00 1 0 0.53 0.00 0.00 No 13.80
15 46 60 60 0.00 1 0 0.41 0.00 0.00 No 0.30
15 47 60 60 0.00 2 0 0.91 0.00 0.00 No 0.60
15 48 60 60 0.00 1 0 0.47 0.00 0.00 No 0.31
34. Response to the alert of high CI
• Heightened vector control activity required in Ward 13 & 14.
• Source reduction within & outside households and public
places.
• Measures to eliminate environmental risk sites.
• Larvicidal spray where water stagnation cannot be
immediately removed or fully covered. Breeding sites within
house premises also to be attended.
• IEC/ IPC for community mobilization.
• Watchfulness for any increase of fever incidence.
• Reporting to Dy.CMOH-II about action taken within 2 days.
• Involving higher authorities, where necessary.
35. Teams not reported; More households visited than in microplan
ULB Wise Daily Monitoring Proforma of --All--(--All--) on 25/Sep/2018
Name of
Municipality
No. of
teams
No. of
teams
reported
Total No.
of House-
holds to be
visited for
the day
No. of
House-
holds
visited for
the day
% of
house-
holds not
visited
No. of
ANY
fever
cases
found
for the
day
No. of fever
cases with
joint
pain/definite
body
ache/vomitin
g/loose
motion
% of
househ
olds
where
larvae
found
No. of
teams
examine
d
containe
rs less
than 2
/househ
old
Percent
age of
containe
rs where
larvae
found
Baidyabati 126 126 7948 7933 0.19 21 0 0.04 0 0.03
Bansberia 90 85 5183 5182 0.02 15 0 0.12 0 0.02
Howrah MC 1193 1193 77059 76939 0.16 428 36 0.30 3 0.05
Uluberia 177 177 10853 11553 -6.45 140 3 0.04 1 0.09
Kamarhati 275 270 16266 16452 -1.14 167 20 0.38 0 0.08
Jhaldah 14 14 819 819 0.00 14 0 0.37 0 0.06
Purulia 85 85 5392 5392 0.00 105 5 1.84 3 1.10
Raghunathp
ur
21 21 1102 1188 -7.80 15 0 0.76 0 0.24
Maybe microplan is faulty or households reported by
Teams is erroneous !
36. Households not visited; No. of Teams checked very few containers
ULB Wise Daily Monitoring Proforma of --All--(--All--) on 25/Sep/2018
Name of
Municipality
No. of
teams
No. of
teams
reported
Total No.
of House-
holds to be
visited for
the day
No. of
House-
holds
visited for
the day
% of
house-
holds
not
visited
No. of
ANY
fever
cases
found for
the day
No. of fever
cases with
joint
pain/definit
e body
ache/vomiti
ng/loose
motion
% of
househol
ds where
larvae
found
No. of
teams
examined
container
s < 2
/house-
hold
Percent
age of
containe
rs where
larvae
found
Baidyabati 126 126 7948 7933 0.19 21 0 0.04 0 0.03
Bansberia 90 85 5183 5182 0.02 15 0 0.12 0 0.02
Howrah MC 1193 1193 77059 76939 0.16 428 36 0.30 3 0.05
Uluberia 177 177 10853 11553 -6.45 140 3 0.04 1 0.09
Kamarhati 275 270 16266 16452 -1.14 167 20 0.38 0 0.08
Purulia 85 85 5392 5392 0.00 105 5 1.84 3 1.10
Raghunathp
ur
21 21 1102 1188 -7.80 15 0 0.76 0 0.24
Jhaldah 14 14 808 621 23.14 22 0 0.64 4 0.10
Contai 63 63 3974 3975 -0.03 32 0 1.89 0 0.33
Panihati 357 357 20899 20487 1.97 127 27 0.00 6 0.04
Pls note the data of Jhalda.
37. Team-wise details showing where the mistakes occurred
Team Wise Daily Proforma of Jhalda (Purulia) on 26/Sep/2018
Ward
No.
Team
No.
Total No. of
House-holds
to be visited
for the day
No. of
House-
holds
visited for
the day
% of
house-
holds not
visited
No. of
ANY
fever
cases
found
for the
day
No. of fever
cases with
joint
pain/definit
e body
ache/vomiti
ng/loose
motion
% of
househ
olds
where
larvae
found
No. of teams
examined
containers <
2 /house-
hold
Percenta
ge of
containe
rs where
larvae
found
5 5 70 70 0.00 0 0 1.43 No 0.23
6 6 83 83 0.00 3 0 1.20 No 0.44
7 7 50 0 100.00 3 0 0.00 Yes 0.00
7 8 50 0 100.00 2 0 0.00 Yes 0.00
8 9 42 0 100.00 2 0 0.00 Yes 0.00
8 10 43 0 100.00 1 0 0.00 Yes 0.00
9 11 60 60 0.00 3 0 0.00 No 0.00
38. Team-wise details: which Team checked very few no. of
containers ; which could found no container with larva
Team Wise Daily Proforma of Panihati (North 24 Pgs) on 26/Sep/2018
Ward
No.
Team No.
Total No.
of House-
holds to
be visited
for the
day
No. of
House-
holds
visited for
the day
% of
house-
holds not
visited
No. of
ANY
fever
cases
found
for the
day
No. of fever
cases with
joint
pain/definit
e body
ache/vomiti
ng/ loose
motion
% of
househol
ds where
larvae
found
No. of teams
examined
containers < 2
/house-hold
Percentage of
containers where
larvae found
34 342 63 62 1.59 0 0 0.00 No 0.00
34 343 63 63 0.00 0 0 0.00 Yes 0.00
34 348 69 69 0.00 0 0 0.00 Yes 0.00
35 349 56 55 1.79 1 1 0.00 Yes 0.00
35 350 54 50 7.41 2 2 0.00 No 0.96
35 351 66 63 4.55 0 0 0.00 Yes 0.00
35 355 60 56 6.67 1 1 0.00 Yes 0.00
35 356 60 56 6.67 1 1 0.00 No 0.00
35 357 60 57 5.00 0 0 0.00 Yes 0.00
39. Parameters of analysis
Sl. No Parameter
1 All Teams Not Reported
2 Percentage Of House Not Visited(>10%)
3 House Visited Exceeds House Planned(>5%)
4 Cluster Of Fever Cases Found
5 Upsurge Of Fever Cases With Joint Pain Vomiting Etc
6 Percentage Of Households Where Larvae Found Is High
7 Significant Number Of Teams Examined < 2 Containers Per Household
8 Percentage Of Containers Where Larvae Found Is High
9 Percentage Of Containers Where Larvae Found Is Nil
10 Fever Percentage High But Container Percentage Low
40. Team-wise details: high % of fever cases
Team Wise Daily Proforma of Tufanganj (Cooch Behar) on 25/Sep/2018
Ward Team
Total
No. of
House
holds
to be
visited
for the
day
No. of
House
holds
visited
for the
day
Percen
tage
of
house
holds
not
visited
No. of
ANY
fever
cases
found
for the
day
No. of fever
cases with
joint
pain/definite
body
ache/vomiti
ng/loose
motion
% of fever
cases
% of Fever
With Jt Pain
Vomiting
Etc
% of
households
where
larvae found
No. of
teams
examin
ed
contain
ers less
than 2
/house
hold
% of
containers
where larvae
found
6 11 60 60 0.00 4 0 2.48 0.00 0.00 No 0.00
6 12 60 60 0.00 0 0 0.00 0.00 5.00 No 1.27
7 13 60 60 0.00 0 0 0.00 0.00 0.00 No 0.00
7 14 60 60 0.00 0 0 0.00 0.00 3.33 No 0.88
8 16 60 60 0.00 0 0 0.00 0.00 3.33 No 1.18
9 17 60 60 0.00 0 0 0.00 0.00 3.33 No 1.44
9 18 60 60 0.00 0 0 0.00 0.00 0.00 No 0.00
10 19 60 60 0.00 8 0 4.62 0.00 0.00 No 0.00
10 20 60 60 0.00 2 0 1.08 0.00 5.00 No 1.06
41. Fever cluster : Actions
1. Verification of cluster and a rapid fever survey – led by
(a) Health Officer/ MO/ Public Health Manager/ SI in case of
urban areas; Nodal Officer (Health) to help.
(b) BMOH/ Medical Officer in rural areas.
2.
Exclusion/ diagnosis of malaria by clinical features and microscopy
&/or RDT. Exclusion of any other common infection if such is likely.
3. If dengue or chikungunya is suspected, collection of blood sample
(serum) from selected cases and testing in nearby SSHL.
4. Focus on vector control if any vector borne disease is detected.
5. Alert to the nearby hospital if an outbreak is suspected.
6. Community awareness generation.
7. Follow-up by community level workers.
42. Daily ULB summary of env. management
District Name
Municipa
lity Name
No. Of
Place
Having
Garbages
No. Of Place
Having Garbage
Action Taken
Percent
Of
Garbage
Managed
No. Of
Blocked
Drains
No. Of
Blocked
Drain
Action
Taken
Percent
Of
Blocked
Drain
Managed
Bankura Bankura 3 3 100 2 2 100
Bardhaman
(East)
Burdwan 11 11 100 8 8 100
Bardhaman
(East)
Dainhat 4 4 100 11 11 100
Bardhaman
(East)
Gushkara 14 14 100 38 38 100
Bardhaman
(East)
Kalna 5 5 100 10 10 100
Bardhaman
(East)
Katwa 0 0 0 4 4 100
Bardhaman
(East)
Memari 3 2 66.67 5 5 100
Birbhum Sainthia 9 9 100 16 16 100
43. Daily ULB summary of environmental
management
• Environmental risk sites divided into 5 groups in the portal:
- Pile of garbage
- Blocked drain
- Low land with stagnant water
- Construction site (not managed for vector breeding)
- Tyre resoling shop/ recycling factory etc.
• For each category, there are 3 columns:
- No. reported
- No. managed
- % managed out of no. reported
• Also , another column showing the date when data was last
updated.
44. Right half of the env. management part
Municipa-
lity
No. Of
Construc-
tion Site
Not
Managed
For Vector
No. Of
Construc-
tion Sites
Not
Managed
For Vector
Action
Taken
Percent Of
Construc-
tion Sites
Managed
For Vector
No. Of
Tyre
Resoling
And Plastic
Recycling
Sites
No. Of
Tyre
Resoling
And
Plastic
Recycling
Sites
Action
Taken
Percent Of
Tyre
Resoling
And Plastic
Recycling
Sites
Managed
Action
Date
Tarakeswar 1 1 100 0 0 0 1/10/2018
Howrah MC 0 0 0 1 1 100 5/10/2018
Dhupguri 14 12 85.71 3 3 100 1/10/2018
Mal Bazar 6 6 100 0 0 0 1/10/2018
Kalimpong 0 0 0 0 0 0 1/10/2018
English
Bazar
0 0 0 0 0 0 3/10/2018
Chandra-
kona
0 0 0 2 2 100 3/10/2018
Ghatal 4 4 100 4 4 100 1/10/2018
45. Round And Municipality Wise Environment Management, from
25/Sep/2018 to 02/Oct/2018
District
Name
Municipali
ty Name
No. Of
Place
Having
Garbages
No. Of Place
Having Garbage
Action Taken
Percent
Of
Garbage
Managed
No. Of
Blocked
Drains
No. Of
Blocked
Drain
Action
Taken
Percent
Of
Blocked
Drain
Managed
Bankura Bankura 17 17 100 19 19 100
Bardhaman
(East)
Burdwan 31 31 100 29 29 100
Bardhaman
(East)
Dainhat 37 37 100 43 43 100
Bardhaman
(East)
Gushkara 64 64 100 213 213 100
Bardhaman
(East)
Kalna 24 24 100 45 45 100
Bardhaman
(East)
Katwa 0 0 0 13 13 100
Bardhaman
(East)
Memari 9 6 66.67 25 21 84
Birbhum Bolpur 26 23 88.46 34 28 82.35
49. Case Management
• Certificate to be submitted by CMOHs on 1.6.19
regarding preparedness on dengue patient admission
at all DHs, SDHs, SGHs and selected vulnerable
BPHCs- preparedness on HR (MO, Nursing staff, LT
etc), training of HRs, availability of equipment, ELISA
test facility, display of treatment protocol in Wards.
• Training of government and private MOs on case
management to be completed by May, 19. IMA may
be requested to issue circular to all districts.
• Completion of training of bed side nursing staff on
case management by middle of May, 19.
50. WHO classification of dengue infections and grading of
severity of DHF
• DHF I: DF plus positive tourniquet test and evidence of
plasma leakage.
• DHF II: Above plus some evidence of spontaneous bleeding
in skin or other organs (black tarry stool, epistaxis, gum
bleeds) and abdominal pain.
• DHF III (DSS): Above plus circulatory failure (weak rapid
pulse, narrow pulse pressure, Hypotension, cold clammy
skin, restlessness).
• DHF IV (DSS): Profound shock with undetectable blood
pressure or pulse.
54. Calculation of maintenance fluid(Holiday and
Segar formula)
Body weight in kg: Maintenance volume for 24 hours
<10 kg 100 ml / kg
10-20
1000+50 ml / kg body weight
exceeding 10 kg
More than 20 kg
1500+20 ml / kg body weight
exceeding 20 kg
55. Case Management
General recommendations for fine tuning of the Dengue Case management
• Administration of specific quantity of IV fluid at specific rate according to the
grade & clinical condition, including the step-down as well.
• Tailor-made IV fluid therapy based on body weight (and also height in obese
persons) instead of an ad-hoc bolus dose.
• Avoidance of IV fluid during the course of illness if there is no suspicion of
hypovolemia and oral intake is good.
• Withdrawal of IV fluid as early as possible after the critical phase is over and
the patient is stable.
• In addition to platelet count and other lab parameters, monitoring of PCV
(haematocrit value) twice daily (at least) in admitted dengue cases is
suggested, since it can give an early clue of plasma leakage through capillaries.
• Capacity building of RMO-s, junior physicians and the referring private
practitioners through in-house programmes will ensure uniformity of
knowledge and practice.
56. Case Management
Early signs of developing shock/ deterioration in a patient
of dengue:
• Sudden drop of body temperature
• Severe/ increasing pain in abdomen
• Abdominal distension
• Nausea turned into vomiting, specially > 3 times
• Narrowing of Pulse pressure
• Increasing tachycardia
• Extreme prostration or lethargy
• Appearance of drowsiness / loss of eye-to-eye contact/
irritability specially in children
• Very little urine output in last 6 hours / High Coloured Urine
• Shortness of breath
• Rising haematocrit (PCV)
57.
58.
59. Death
• In an event of death in a dengue case, preliminary
information to be sent instantly in e-mail.
• Later the following documents must be submitted in
e-mail to District & State IDSP Cell and NVBDCP
Wing within 48 hours:
• 1. Case Summary.
• 2. Scanned copy of BHT.
• 3. Death certificate.
• 4. All investigation reports.
61. • Identifications of vulnerable wards and Gram panchayets
for intense activities.
• Formation of ULB Level Monitoring Team (ULMT).
• Formation of Citizen Task force / involvement of VHSNC.
• Group meetings in vulnerable communities – with
demonstration of mosquito larva.
- Purpose is to gear up community mobilization for
source reduction.
• Streamlining of case management protocol through out
the state (both govt. and pvt. Sector).
