Preface

A CHAMELEON is hidden in the jumble of numbers.

The above picture depicts a chameleon. As any chameleon, it is adapted to the background, which in this case is a repeating pattern of numbers. However, there is a certain technique of looking at the pattern which makes the chameleon visible. The eyes must fix a virtual point behind the picture, while at the same time the lenses are focused at the picture. This avoids the natural coordination of fixation and accommodation of the visual organs and provides an image to the left eye which is shifted by one pattern compared to the image for the right eye. The visual cortex merges both images and interprets the differences of the respective patterns as spatial information. The shape of the chameleon appears as a virtual image in front of the actual picture. ([SIMETH and SANDER (1995)], picture created with "Stareo V1.02")

Managers of health services are also expected to retrieve information from a jumble of numbers as guideline for decision making. Interpreting existing processes in a health system from available data is a very difficult task, which requires a variety of techniques. It is my wish that the results of this thesis shall contribute at least a little to support that task.

While the official aim of my deployment in Fort Portal, Uganda, was solely centered around organizational aspects of a health system, the unofficial aspects of the deployment helped me to revise my personal image of contemporary African culture, which was strongly based on biased facts from media of the so called First World. With regard to the initial quote of this thesis, I therefore want to thank all my Ugandan friends for getting me off the kitchen-stool and helping me to see and understand the people behind the facts. Especially I want to thank the people in and around New Safari Lodge and White Rhino Tea Room, Fort Portal, the students from Nakawa School of Business and Makarere University, Kampala, and the families of Dr. Bannet Ndyanabangi and Mrs. Julie Kitariko for their friendship and support.

Also, I want to thank Dr. Christoph Bunge for initiating the deployment and for his professional advise and encouragement before and during the deployment, Dr. Walter Kipp for inviting me to Fort Portal, Dr. Wolfgang Weber for the fruitful conversations on health information systems, and Dr. Andrea Knigge and Dr. Henning Moor for organizational and emotional support in Fort Portal.

I strongly recognize the financial support of GTZ, Germany, for the flight tickets and the cost of living of three months. I thank all the staff members of the district health team of Kabarole and of the Western Uganda Basic Health Services Program for their friendship, co-operation and logistic support. Also, I acknowledge the special rebate on the "dGE" graphics library by the Gebhard Heiler GmbH, Korntal-Münchingen.

Special tribute I pay to Prof. Claus O. Köhler and to Prof. Hans-Jochen Diesfeld for their interest in the intersectoral topic of this thesis and their willingness to take over the duties of the examiners. I also want to thank them for their scientific advice and their encouragement.

For an inspection of the English grammar and vocabulary in this thesis, I owe acknowledgments to Mr. and Mrs. Edwin and Lilly Ampadu, and also to Mr. Jens Endtner.

Last not least I am very grateful to my parents for their patience and understanding, but also for filling the gap between available resources and actual needs not only during the time of the deployment in Fort Portal, but also throughout my whole life as a student.