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National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.

Changes in the political and economic situation in the Kyrgyz Republic in the 90s of the XX century, to a certain degree, had an impact on the health of the population as related to the availability and quality of medical care, especially at the primary level. Naturally, the indicator of the disease prevalence and incidence of the population is one of the most important parameters of the effectiveness of health resource provision, planning of medical care and preventive measures for specific age and social groups. The purpose of the study was to assess the level of the disease prevalence and incidence of the urban population of the Bishkek megacity in comparison with the national level. Data on the disease prevalence and incidence of the population of the Bishkek city population were from the Electronic Health Center of the Ministry of Health of the Kyrgyz Republic for the period 1989-2019 and were compared with the national level. Analytical, statistical and comparative analysis methods were used and data processed with the MS Excel 2021 and SPSS-16 software packages. There is definitely a multidirectional dynamics of the disease prevalence and incidence of the population of the entire country and the city Bishkek during the observation period 1989-2019. However, the disease prevalence in absolute figures shows an increasing growth rate tendency 6.2% (1999) to 5.7% (2009) and 7.0% (2019) and a decline in the relative indicator -5,4%, -5,0% and -10.8% respectively. Bishkek’s absolute numbers fell sharply in 1999 (-30,6%), and 2009 saw an increase of up to 637 252 cases (+56%) and 2019 (926845 or +45,4%) and was similar by the relative number per 100,000 population: +42,5%,+41,8%, +17,3% respectively, which indicates the general increased load on the urban health care system. The disease incidence revealed fluctuations in absolute values and per 100,000 population both in the entire country and Bishkek, with decreasing tendencies by 1999 and an increase in subsequent decades, especially in the group of children and adolescents. In the gender aspect, there is a decrease in the disease morbidity in men and growth in women against the background of variations observed in disease incidence indicators by age groups. The results obtained indicate the uneven dynamics of morbidity in different age and social groups of the urban population compared with the national values. The observed increase in population morbidity in the Bishkek megacity largely correlates with the increasing population size and the state of the city's primary health care network, as well as staffing. At the same time, differences are seen in the gender aspect for the entire country: among men, the incidence was decreasing, while among women there were growing tendencies, and on the contrary, in Bishkek there was a general trend of increasing morbidity among all categories of the population. The presented results indicate the problems of organizing primary health care in the whole country and in Bishkek, especially for the male population, related to healthcare access and shortcomings in the organization of preventive work. Thus, the dynamics of the disease prevalence and incidence in the population of the entire country and the metropolitan area demonstrates multidirectional tendencies, showing shortcomings in the planning and implementation of national programs aimed at strengthening and improving the primary health care system. Overall, this indicates the need to review strategies and approaches to ensure more effective healthcare management.

Since the collapse of the Soviet Union in the early 1990s, there has been remarkable enthusiasm for theorising how transitional processes have unfolded in post-socialist cities. In seeking to extend literature that uses the post-socialist condition as a tool for theory building, we draw attention to the ongoing processes of institutional change in post-socialist cities. In doing so, we reject a 'top-down' perspective and examine how these institutional transitions are shaped through processes of 'domestication', negotiation and contestation between different interest groups in the city. We develop our argument, by drawing attention to the local political debates surrounding the propiska in Bishkek, Kyrgyzstan. The propiska developed throughout the Soviet Union to control internal migration and is still used today in a less restrictive form. By discussing our case study, we hope to foster attention towards the ongoing contested processes of institutional transition in post-socialist cities.

Dust storms not only affect the quality of life but also pose a serious health and social problem. The main source dust events include central and west Asia, the Taklimakan desert, and Middle East, carrying out high volume of particulate matter, which increased the level of PM 10 as representative of dust storm. The purpose of this study was to investigate the number of mortality (TM), hospitalizations due to cardiovascular diseases (HACD) and respiratory diseases (HARD) among the people of Bishkek and Ahvaz. Data validation was performed using the WHO criteria. The average time PM 10 in outdoor air was calculated, and its health effects were obtained by entering its annual data and population at risk, baseline incidence (BI), and relative risk index (RR) for IHD outcomes. In our study, AirQ software was used. The number of excess cases in Bishkek and Ahvaz for total mortality and cardiovascular mortality was 63 and 758 and 35 and 478 persons while for HARD and HACD was 84 and 2054 and 33 and 560 persons, respectively. The survey requires the need to enact and enforce permissible PM 10 levels/standards due to dust storms to reduce the health effect on humans by relevant environmental authorities both at federal and state levels.

Organisational culture and job satisfaction are crucial insofar as human resources are the most valuable resources organisations have in today's business world. Organisational culture encompasses the characteristics that unite and integrate employees of an organisation and distinguish them from employees of other institutions. An employee who has high job satisfaction is an employee who enjoys his/her job and is satisfied with the conditions provided by the organisation. By doing the best that they can do, employees with high job satisfaction ensure that the institution has a competitive advantage and, as a result, extends its life. In this study, questions about organisational culture, levels of job satisfaction and factors influencing them were examined in higher education institutions in Bishkek, Kyrgyzstan. Determining the relationship between organisational culture and job satisfaction in higher education institutions was also one of the objectives of this study. In this study, factors influencing organisational culture and job satisfaction in the case of higher education institutions in the service sector were investigated. In line with the research objective, a questionnaire was conducted in order to be able to explain the factors influencing organisational culture and job satisfaction of university employees and describe the relationship that exists, if any, between organisational culture and job satisfaction. Results showed that there is a significant linear and positive correlation between organisational culture and job satisfaction at a level of 47.2 %, which corresponded to a medium strength. In this case, an improvement in organisational culture will cause an increase in job satisfaction.

Many cities are built on or near active faults, which pose seismic hazard and risk to the urban population. This risk is exacerbated by city expansion, which may obscure signs of active faulting. Here, we estimate the risk to Bishkek city, Kyrgyzstan, due to realistic earthquake scenarios based on historic earthquakes in the region and an improved knowledge of the active fault sources. We use previous literature and fault mapping, combined with new high-resolution digital elevation models to identify and characterise faults that pose a risk to Bishkek. We then estimate the hazard (ground shaking), damage to residential buildings and distribution of losses (economical cost and fatalities) using the Global Earthquake Model OpenQuake engine. We model historical events and hypothetical events on a variety of faults that could plausibly host significant earthquakes. This includes proximal, recognised, faults as well as a fault under folding in the north of the city that we identify using satellite DEMs. We find that potential earthquakes on faults nearest to Bishkek—Issyk Ata, Shamsi Tunduk, Chonkurchak and the northern fault—would cause the most damage to the city. An Mw 7.5 earthquake on the Issyk Ata fault could potentially cause 7900 ± 2600 completely damaged buildings, a further 16,400 ± 2000 damaged buildings and 2400 ± 1500 fatalities. It is vital to properly identify, characterise and model active faults near cities to reduce uncertainty as modelling the northern fault as a Mw 6.5 instead of Mw 6.0 would result in 37% more completely damaged buildings and 48% more fatalities.

The present article aims to describe the status quo of the atmospheric air quality in Bishkek and the state measures taken to improve it and to give the perspective of research and policy development. Air pollution is one of the major environmental risks for premature death from respiratory diseases, cancer, strokes, heart attacks, diabetes, and other diseases. It exerts a negative effect on worker productivity and mental health. In the last 30 years, Bishkek, the capital of the Kyrgyz Republic, has turned from one of the cleanest and greenest cities in the former Soviet Union to one of the most polluted cities in the world. The roots of that transformation lie in the negative socio‐economic changes taking place in the country, including the population doubling of Bishkek mainly due to internal migration, uncontrolled construction of houses without relevant infrastructure, worsening socio‐economic conditions, increased number of used vehicles, and low quality of gasoline. The main sources of air pollution in Bishkek are domestic heating and vehicle exhaust fumes. During the winter, air pollution is aggravated by frequent temperature inversion and air stagnation due to air trapping by high‐rise buildings. The state's approaches and measures to address this issue are reflected in its laws and policies. The city and national government have taken a range of strategic measures to transform Bishkek into a green city with a favourable environment. Recommendations on research and policy development are provided in this perspective.

Natural hazards such as earthquakes threaten millions of people all around the world. In a few decades, most of these people will live in fast-growing, inter-connected urban environments. Assessing risk will, therefore, be an increasingly difficult task that will require new, multidisciplinary approaches to be tackled properly. We propose a novel approach based on different imaging technologies and a Bayesian information integration scheme to characterize exposure and vulnerability models, which are among the key components of seismic risk assessment.

The World Nomad Games (WNG) is a new form of large-scale events in the world. Thus, little empirical research is focused on understanding perceived impacts of the WNG and behavioural tendencies of the host community. The research aims to reveal the perceptions of the local people regarding the possible impacts from hosting the World Nomad Games in two different localities of the Kyrgyz Republic. The impacts of the WNG were measured using a survey conducted among local residents based on face-to-face interviews. The study examines data collected from two localities in the Kyrgyz Republic: 384 surveys from Bishkek, the capital city of Kyrgyzstan (first group), and 286 interviews from Issyk-Kul region where the WNG were held (second group). According to the results, the local residents have positive perceptions about the impacts of the WNG and support hosting this event in Kyrgyzstan. The residents believe that the WNG result in the economic development, revitalization of the tourism sector, increased infrastructure investments. Moreover, the positive impacts include preservation and development of local cultures, host country promotion and enhancement of the country’s image. However, hosting the WNG created different impacts in different localities. In this context, for the Bishkek sample, the economic dimension was the most important factor, while for the Issyk-Kul sample the cultural dimension came to the forefront.