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A lthough the negative effects of second-hand smoke are well known, few studies have examined the impact of smokefree legislation on cardiac hospital admissions. This study extends research in New Zealand by considering associations with smoking status and area deprivation. The paper suggests that the implementation of the 2004 smokefree policy led to a reduction of admissions for acute myocardial infarction particularly among men aged between 55 and 74 and older people who had never smoked. There was a suggestion of reductions for people living in less deprived neighbourhoods however, the reduction in AMI rates did not occur for all population groups and was not consistent by age, sex, smoking status or deprivation. Furthermore, the magnitude of the reduction in AMI rates is less than that reported in previous research, and possibly reflects the focus in this study on first as compared to multiple admissions.

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Background: Studies evaluating development of health information systems in developing countries are limited. Most of the available studies are based on pilot projects or cross-sectional studies. We took a longitudinal approach to analysing the development of Botswana’s health information systems.Objectives: We aimed to: (i) trace the development of the national health information systems in Botswana (ii) identify pitfalls during development and prospects that could be maximized to strengthen the system; and (iii) draw lessons for Botswana and other countries working on establishing or improving their health information systems.Methods: This article is based on data collected through document analysis and key informant interviews with policy makers, senior managers and staff of the Ministry of Health and senior officers from various stakeholder organizations.Results: Lack of central coordination, weak leadership, weak policy and regulatory frameworks, and inadequate resources limited development of the national health information systems in Botswana. Lack of attention to issues of organizational structure is one of the major pitfalls.Conclusion: The ongoing reorganization of the Ministry of Health provides opportunity to reposition the health information system function. The current efforts including development of the health information management policy and plan could enhance the health information management system.