Green Star: An Innovative Approach to Engage Medicine and Health Product Seller in Delivering Primary Healthcare Services
Green Star Program was initiated in 2018. It is an effective and innovative network of SMC to ensure minimum primary health care service through them. Under this network, providers are called Green Star Providers (GSPs who are basically medicine and public health products sellers. In many cases, GSPs are the primary contact for public health services at the community level. They promote rational use of drugs as well. Depending on their locations, GSPs often act as point-of-contact for people seeking remedies for minor ailments, such as diarrhea, cough, fever, weakness, helminthiasis, etc.
Initially the program engaged the providers to administer follow-up doses of injectable contraceptive services and to provide nutritional counselling to caregivers/mothers of children under five. At present, GSPs refer suspected TB cases and potential Long-acting and Permanent Method clients to the nearest service delivery center. They also offer basic pregnancy care services, which includes; measuring weight and blood pressure, blood glucose, urinary albumin and sugar test by strip and counseling on 5 danger signs & offer multiple micronutrient supplements (MMS) and calcium during pregnancy. Upon assessment, they also refer risk pregnancies to the appropriate health facilities. SMC took a special initiative to scale up the capacity of the providers for offering nutrition services. Selected Green Star providers started to offer Growth Monitoring and Promotion (GMP) services.
Selection criteria for Green Star providers include minimum SSC level education, a pharmacy with a separate space for counselling and services, has female and child client flow, valid drug license, at least two years of business experience, and willingness to attend training programs of SMC. At the beginning, SMC provides two-days long basic training to the GSPs, using a comprehensive training curriculum on specific public health issues such as, injectable contraceptives, necessary messages on nutrition for children under five, referral for potential TB cases and potential Long-acting and Permanent Method clients, counselling skills for pregnant mothers, benefits of consumption of zinc and rational use of drugs etc. They also undergo refresher training to resolve various kinds of problems they face during service delivery at their facilities. SMC personnel, mostly Program Officers periodically visit the Green Star outlets and provide on-site technical assistance to improve their knowledge and skills.
· 0.86 million vials of injectables sold
· 7.51 million sachets of Micronutrient Powder distributed to prevent Iron Deficiency Anemia among under-5 children
· 0.39 million Multiple Micronutrient Supplements blisters sold for pregnant women
· 1.43 million Deworming tablets sold
· 85 thousand Zinc tablets sold as an adjunct therapy for diarrhea
· 31 thousand Forbon tablets sold (January - December, 2023)
Green Star service delivery outlets are branded with different materials like, signage, stickers, and posters. SMC promotes Green Star outlets and the network through comprehensive demand creation activities by using local media like miking, distributing brochure, leaflet, etc. Currently, Green Star network has more than 5,500 providers across the country. One-third of them are based in urban areas and the rest are in rural areas.
Green Star providers use Electronic Reporting System through Interactive Voice Response, a technology-based electronic reporting system to send their monthly performance reports to SMC. The performance report includes injectable administration, referral service, and other major public health product distribution.
| Green Star provider coverage by divisions (June, 2024) |
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| Divisions | Rural | % Rural | Urban | % Urban | Total |
| Dhaka | 467 | 35 | 864 | 65 | 1331 |
| Chattogram | 719 | 72 | 278 | 28 | 997 |
| Rajshahi | 588 | 82 | 132 | 18 | 720 |
| Khulna | 523 | 70 | 220 | 30 | 743 |
| Rangpur | 393 | 70 | 166 | 30 | 559 |
| Sylhet | 228 | 62 | 142 | 38 | 370 |
| Barishal | 276 | 67 | 135 | 33 | 411 |
| Mymensingh | 204 | 66 | 106 | 34 | 310 |
| Total | 3,398 | 62 | 2,043 | 38 | 5,441 |
