Asnakew Ayele is a health science researcher with research interest that employed advanced statistical analyses, mixed methods, qualitative study, survey, and simulated client visit. Asnakew has a wide range of research experience including pharmacy practice, patient reported outcome, medication regimen complexity, health services and health systems research, global health, non-communicable disease (diabetes and hypertension) and public health (with a specific emphasis on maternal and child health). He authored and co-authored more than 30 publications in highly reputable journals. In terms of teaching experience, he has been teaching various pharmacy courses in the University of Gondar in Ethiopia since 2016.
EDUCATION
PhD, MPH, MSc, BPharm
RESEARCH INTERESTS
Pharmacy practice, patient reported outcome, medication regimen complexity, deprescribing, policy pharmacy, health services and health systems research, maternal and child health
Involvement of community pharmacy professionals in maternal health service provision in Ethiopia: A multi-centre cross-sectional survey Asnakew Achaw Ayele, Md Shahidul Islam, Suzanne Cosh, Leah East Journal of Pharmaceutical Health Services Research, 2023 Objectives In countries with high maternal mortality and a shortage of healthcare professionals, community pharmacy professionals can provide important maternal healthcare services within their scope of practice. Evidence of community pharmacy professionals’ level of involvement in maternal health service provision in Ethiopia is limited. This study aimed to assess the level of involvement of community pharmacy professionals in providing maternal health services in Ethiopia. Methods A multi-centre cross-sectional survey of 238 community pharmacy professionals was conducted from March to July 2020 in 6 cities of Amhara regional state in Ethiopia. Independent samples t-test and one-way analysis of variance (ANOVA) were used to test the mean difference. Key findings Most community pharmacy professionals were either ‘involved’ in advising about vitamins (53.4%), provision of contraceptives (52.9%), advising about lifestyle changes (46.2%), responding to minor symptoms (47.5%), nutritional advice during pregnancy (45.0%) and breastfeeding guidance or ‘very involved’ in advising about screening for chronic disease (41.6%). However, the level of involvement of community pharmacy professionals differed according to study participants’ educational qualification/s, years of experience, licensure level, setting type, responsibility in the facility and previous training exposure about maternal health services. Conclusions Community pharmacy professionals in Ethiopia are involved in providing various maternal health services highlighting the importance that pharmacists can play in improving access and care within this context. However, government attention is needed to enhance their role through policy support and capacity building to improve the quality of service provided which could contribute to the reduction of maternal mortality.
Role of community pharmacy professionals in child health service provision in Ethiopia: a cross-sectional survey in six cities of Amhara regional state Asnakew Achaw Ayele, Suzanne Cosh, Md Shahidul Islam, Leah East BMC Health Services Research, 2022 Background Community pharmacy professionals have great potential to deliver various public health services aimed at improving service access, particularly in countries with a shortage of health professionals. However, little is known about their involvement in child health service provision in Ethiopia. Objective The purpose of this study was to evaluate the level of involvement of community pharmacy professionals in child health service provision within Ethiopia. Methods A multi-center cross-sectional survey was conducted among 238 community pharmacy professionals from March to July 2020 in Amhara regional state of Ethiopia. Independent samples t-test and one way Analysis of Variance (ANOVA) was used to test the mean difference. Results Most community pharmacy professionals were ‘involved’ in providing child health services related to ‘advice about vitamins/supplements’ (46.6%), ‘advice about infant milk/formulas’ (47.1%) and ‘responding to minor symptoms’ (50.8%) for children. The survey revealed that, community pharmacy professionals were less frequently involved in providing childhood ‘vaccination’ services. Further, level of involvement of community pharmacy professionals differed according to participants’ licensure level, setting type, responsibility in the facility and previous training experience in child health services. Conclusion Community pharmacy professionals have been delivering various levels of child health services, demonstrating ability and capacity in improving access to child health services in Ethiopia. However, there is a need for training and government support to optimize pharmacist engagement and contribution to service delivery.
Community pharmacy professionals’ practice in responding to minor symptoms experienced by pregnant women in Ethiopia: results from sequential mixed methods Asnakew Achaw Ayele, Md Shahidul Islam, Suzanne Cosh, Leah East Journal of Pharmaceutical Policy and Practice, 2022 Background In countries with limited access to healthcare services, community pharmacists’ management of minor symptoms experienced by pregnant women could be beneficial in terms of alleviating the burden of other health professionals and cost of services. However, evidence is limited regarding the practice of community pharmacy professionals in responding to minor pregnancy-related symptoms more generally, particularly in Ethiopia. Objective The aim of this study was to evaluate actual and self-reported practice of community pharmacists in the management of minor symptoms during pregnancy in Ethiopia. Methods A sequential mixed method study using self-reported survey from 238 community pharmacists followed by 66 simulated client visits was conducted from March to July 2020 in six towns of the Amhara regional state in Ethiopia. Independent samples t-test and one-way Analysis of Variance was used to test the mean difference of practice score among subgroups of study participants. Results The self-reported survey showed that most community pharmacist would ‘always’ gather most symptom-related information particularly about ‘duration of symptoms,’ ‘frequency of symptoms,’ and ‘gestational age’ and provide medication-related information on ‘how to use the medication’ and ‘duration of use.’ The highest mean practice scores were observed in relation to information gathering about ‘gestational age’ and information provision on ‘how to use the medication.’ In contrast, the lowest mean practice scores were observed in relation to information gathering about ‘weight of the woman’ and information provision on ‘dosage form.’ However, the actual practice, as revealed by the simulated client visits, demonstrated that most community pharmacists would rarely gather symptom-related information nor provide medication-related information. In addition, dispensing of non-prescribed medications to pregnant women was also common. The extent of self-reported practice differed among subgroups of study participants. Conclusions This study highlights extent of practice of community pharmacy professionals during the management of minor symptoms in pregnancy in Ethiopia. Discrepancies of results between self-reported and actual practices of community pharmacy professionals were observed. The inadequate actual practice of symptom-related information gathering and medication-related information provisions needs considerations of implementing interventions to minimize potential harms.
Determinants of under-five mortality in Ethiopia using the recent 2019 Ethiopian demographic and health survey data: nested shared frailty survival analysis Belete Achamyelew Ayele, Sofonyas Abebaw Tiruneh, Melkalem Mamuye Azanaw, Habtamu Shimels Hailemeskel, Yonas Akalu, et al. Archives of Public Health, 2022 Background Worldwide, there is remarkable progress in child survival in the past three decades. Ethiopia is off-track on sustainable development targets in under-five mortality since 2020. Therefore, this study aimed to investigate time to death and its associated factors among under-five children in Ethiopia. Methods Nationally representative demographic and health survey data were used for this study. A total of 5772 under-five children were included. Data were analyzed using R software. Semi-parametric nested shared frailty survival analysis was employed to identify factors affecting under-five mortality. Adjusted hazard ratio (AHR) with 95% Confidence interval (CI) was reported and log-likelihood was used for model comparison. Statistical significance was declared at P-value < 0.05. Results The weighted incidence of under-five death before celebrating the first fifth year was 5.76% (95% CI: 5.17 – 6.40). Female sex and under-five children living in urban areas were high probability of survival than their counterparts. After controlling cluster and region level frailty, multiple births (AHR = 7.03, 95% CI: 4.40—11.24), breastfed within one hour after birth (AHR = 0.41, 95% CI: 0.28—0.61), preceding birth interval 18–23 months (AHR = 1.62, 95% CI: 1.12 -2.36), and under-five children younger than 18 months (AHR = 2.73, 95% CI: 1.93 -3.86), and teenage pregnancy (AHR = 1.70, 95% CI: 1.01—2.87) were statistically significant factors for time to under-five death. Conclusion Even though Ethiopia has a significant decline under-five death, still a significant number of under-five children were dying. Early initiation of breastfeeding, preceding birth interval and teenage pregnancy were the preventable factors of under-five mortality. To curve and achieve the SDG targets regarding under-five mortality in Ethiopia, policymakers and health planners should give prior attention to preventable factors for under-five mortality.
Prevalence and determinants of overweight/obesity among under-five children in sub-Saharan Africa: a multilevel analysis Belete Achamyelew Ayele, Sofonyas Abebaw Tiruneh, Asnakew Achaw Ayele, Melkamu Aderajew Zemene, Ermias Sisay Chanie, et al. BMC Pediatrics, 2022 Introduction Childhood obesity has become a major public health problem for both developed and developing nations. It is uncommon to find under-nutrition in many low and middle-income countries; as well, obesity is a double burden in these settings. This study aimed to investigate the pooled prevalence of overweight /obesity among under-five (under-5) children in sub-Saharan Africa (SSA). Methods Data were accessed from the recent nationally representative demographic and health survey datasets from 33 SSA Countries. A total of 192,132 under-five children were recruited for this study. The pooled prevalence of overweight /obesity among under-5 was done using random-effects meta-analysis command. Multivariable multi-level mixed-effects logistic regression analysis was used to identify determinants for the prevalence of under-5 overweight and/or obesity. A P-value less than 0.05 was used to declare statistical significance. Results The pooled prevalence of overweight /obesity among under-5 was 5.10% (9% CI: 4.45 – 5.76) in SSA. South Africa region (8.80%, 95% CI: 4.18 – 13.42) had a higher prevalence of under-5 overweight and/or obesity followed by the East Africa region. Male under-5 children (adjusted odds ratio (AOR) = 1.09, 95 confidence interval (CI): 1.02 – 1.25), Larger birth weight under-5 children (AOR = 1.39, 95% CI: 1.26 – 1.54), under-5 children aged older two to three years (AOR = 0.85, 95% CI: 0.76 – 0.94), under-5 children born from educated mothers (secondary and above) (AOR = 1.12, 95% CI: 1.01 – 1.25), and under-5 children living in the West Africa (AOR = 0.67, 95% CI: 0.56 – 0.81) and South Africa (AOR = 1.87, 95% CI: 1.09 – 3.21) were significant determinants for under-5 overweight and/or obesity. Conclusion Childhood obesity is becoming a great challenge and double burden in developing nations. In SSA Africa 1 in 20 under 5 children were overweight and/or obese. Male under-5 children, older aged, under-5 children born from educated mothers, and under-5 children living in the South Africa region were at higher risk for developing overweight and/or obesity. Thus, SSA countries should implement early to pause these consequences preventing the double burden of undernutrition.
Ethiopia’s commitment towards achieving sustainable development goal on reduction of maternal mortality: There is a long way to go Asnakew Achaw Ayele, Yonas Getaye Tefera, Leah East Women S Health, 2021 Maternal mortality reduction has been recognized as a key healthcare problem that requires prioritizing in addressing. In 2015, the United Nations has set Sustainable Development Goals to reduce global maternal mortality ratio to 70 per 100,000 live births by 2030. Ethiopia as a member country has been working to achieve this Sustainable Development Goals target for the last decades. In this article, we discussed Ethiopia’s commitment towards achieving Sustainable Development Goals in maternal mortality. Furthermore, the trends of maternal mortality rate in Ethiopia during Millennium Development Goals and Sustainable Development Goals are also highlighted. Although maternal mortality has been declining in Ethiopia from 2000 to 2016, the rate of death is still unacceptably high. This requires many efforts now and in future to achieve the Sustainable Development Goals target by 2030.
Unmet supportive care needs and determinants among cancer patients treated at University of Gondar Specialized Hospital, Northwest Ethiopia: A prospective cross-sectional study Begashaw Melaku Gebresillassie, Asnakew Achaw Ayele, Tadesse Melaku Abegaz Journal of Oncology Pharmacy Practice, 2021 Background Assessment of supportive care needs is an important requirement to plan supportive care intervention. This study aimed to assess the unmet supportive care needs of cancer patients treated at the University of Gondar Specialized Hospital, Ethiopia. Methods A prospective cross-sectional study was conducted from January 1, 2017 to August 30, 2017. Adult (18 years and greater) cancer patients and those who were receiving therapy were included. The 34-Item short-form Supportive Care Needs Survey(SCNS-SF34) tool was used to assess unmet needs. The data collected were analyzed using SPSS version-21. Results A total of 150 interview guides were included in the analysis (97.4% of response rate). In the majority of 65(43.3%) the participants, the disease was metastasized even though they have undergone surgery 78 (52%). The overall mean score level of unmet need for cancer care was 3.49. The highest unmet need mean score was reported from the health system and information need domain. A significant unmet need difference concerning different need domain was found in sex, age, residence, occupation status, and monthly income. Sex and residence were found to be independent predicting factors for unmet supportive care needs. Conclusion The overall level of unmet need was high. A significant unmet need difference was found in sex, age, residence, occupation status, and monthly income. Sex and residence were found to be independent predicting factors. Hence, professionals working in the oncology unit should be aware of unmet needs and expect changes over time. Certain programs and services to address the identified unmet needs should be urgently provided.
