Factors Associated with Incomplete Childhood Immunization among Residents in St Mary, Jamaica

Aim: To investigate factors associated with caregiver failure to complete immunizations for their children in the parish of St Mary, Jamaica. Methods: A case-control study was conducted with 50 cases defined as caregivers who failed to immunize their children and 179 controls defined as caregivers of children who were properly immunized. The cases were caregivers of children who were randomly selected from clinic records of children who failed to complete their immunization within the study period. Controls were caregivers of children who were identified to have completed their immunization from a similar list. Cases and controls were visited at home and interviewed using a validated questionnaire. Cases and controls were compared in terms of socio-demographic, economic and other variables. Results: Participants with less than secondary school education were more likely to be non-compliant (odds ratio [OR], 2.51, 95% confidence interval [CI], 1.06 − 5.97), while participants who were aware of legislation against non-compliance with immunization (OR, 0.35; 95% CI, 0.17, 0.69) were less likely to fail to immunize their children. Conclusion: Policy-makers and programme managers need to use established educational and communication channels to increase awareness of childhood immunization especially among families with lower educational levels in the parish. Keywords: Defaulting, determinants, immunization, Jamaica "Factores Asociados con la Inmunización Infantil Incompleta en Residentes de Saint Mary, Jamaica" FMB Shuaib, D Kimbrough, M Roofe, G McGwin Jr, P Jolly RESUMEN Objetivo: Investigar los factores asociados con el fracaso de los encargados del cuidado infantil en cuanto a garantizar la completa inmunización de los niños en la Parroquia de Saint Mary, Jamaica. Métodos: Se llevó a cabo un estudio de caso-control con 50 casos definidos como encargados de cuidado infantil que dejaron de hacer inmunizar a sus niños y 179 controles definidos como encargados del cuidado de niños que fueron debidamente inmunizados. Los casos eran cuidadores de niños que fueron seleccionados de forma aleatoria a partir de las historias clínicas de niños que no completaron su inmunización dentro del periodo de estudio. Por el contrario, en el caso de los controles se trataba de encargados del cuidado de niños identificados por haber completado su inmunización a partir de una lista similar. Tanto los casos como los controles recibieron una visita en sus casas, y fueron entrevistados usando una encuesta validada. Ambos – casos y controles – fueron comparados en términos de sus aspectos socio-demográficos y económicos, así como otras variables. Resultados: Los participantes con un nivel de escolaridad por debajo de la enseñanza secundaria presentaron una mayor probabilidad de ser incumplidores (odds ratio [OR], 2.51, 95% intervalo de confianza [IC], 1.06 − 5.97), mientras que los participantes que sabían de la legislación contra el incumplimiento de la inmunización (OR, 0.35; 95% CI, 0.17 − 0.69) presentaron una menor probabilidad de dejar de inmunizar a sus niños. Conclusión: Los encargados de trazar políticas y los administradores de programas necesitan usar los canales de comunicación y educación – sobre todo entre las familias con nivel educacional más bajo – con el propósito de lograr una mayor concientización en torno a la necesidad de inmunizar a todos los niños de la parroquia. Palabras claves: Omisión, determinantes, inmunización, Jamaic

School leadership, curriculum diversity, social justice and critical perspectives in education

In the face of changing demographics, reduced funding and more stringent accountability and performance measures, school leaders are required to make schools fairer for all students, and to equip them with critical skills for autonomous living in society. Simultaneously, financial and material resources from government to schools have been reduced, thus producing a mismatch between expectations and reality. This qualitative study of 12 principals in England, Jamaica and Spain interrogates international discourses on school leadership and curriculum diversity to identify and evaluate social justice practices of school leaders in small rural/remote schools. There was a shared understanding of social justice among principals, who saw the school curriculum as a social justice tool, and school context as providing both challenges and opportunities to doing social justice work, and who suggested a shared responsibility among stakeholders for a social justice curriculum