Children's Absenteeism Research Articles

Antibiotic use and class absenteeism in children with influenza-like-illness in an emergency department.

Children with influenza-like-illness (ILI) often require clinician clearance or antibiotics to return to child care or school. Study objectives were to examine the association between antibiotic receipt during an Emergency Department (ED) visit for ILI and the outcomes of class absenteeism and illness duration. A secondary analysis of 251 children aged 2 months to 12 years with uncomplicated ILI discharged from the ED from December 1, 2018 to November 30, 2019 was conducted. The primary exposure was receipt of antibiotics over the course of illness (assessed by chart review and family follow-up survey). Patients prescribed antibiotics (n = 65) experienced a median of 3 (interquartile range [IQR]: 1,5) days of class missed and 5 (IQR: 3,7) days of illness compared to 2 (IQR: 1,4) days of class missed and 4 (IQR: 3,7) days of illness for those not prescribed antibiotics (n = 186, p = 0.08 and p = 0.13, respectively). There was no statistically significant association with missed class days (incidence rate ratio [IRR]: 1.14 [0.86-1.50], p = 0.37) or days of illness (IRR: 1.06 [0.88-1.27], p = 0.55) for patients prescribed antibiotics compared to patients not prescribed antibiotics for ILI. Antibiotic use for ILI was not associated with reduced class absenteeism or illness duration. Child care centers and schools sometimes exclude children with influenza-like-illness (ILI) from class until cleared to return by a clinician and/or prescribed antibiotics. This study addresses these social drivers of overprescribing. Antibiotics were prescribed in 26% of children with ILI discharged from a large Emergency Department in the US. Antibiotic use was not significantly associated with class absenteeism or illness duration. This study can serve as a discussion point for clinicians when navigating parental or social pressures to prescribe antibiotics for uncomplicated acute respiratory tract infections, particularly when these pressures are influenced by concerns about returning to class.

P374 Effect of CFTR-modulators on cystic fibrosis related school absenteeism in children attending primary school

P374 Effect of CFTR-modulators on cystic fibrosis related school absenteeism in children attending primary school

School Absenteeism In Children And Factors Associated With School Absenteeism

School Absenteeism In Children And Factors Associated With School Absenteeism

Effectiveness of COVID-19 vaccination against school absenteeism in children and adolescents hospitalized with COVID-19

BackgroundCOVID-19 vaccination has been recommended for children to protect them and to enable in-person educational and social activities. MethodsWe estimated COVID-19 vaccination effectiveness (VE) against school absenteeism in children 5–17 years old hospitalized from September 1, 2021 through May 31, 2023. Full vaccination was defined as two vaccine doses. ResultsWe studied 231 children admitted to hospital with COVID-19, including 206 (89.2 %) unvaccinated/partially vaccinated and 25 (10.8 %) fully vaccinated. Unvaccinated/partially vaccinated children were absent from school for longer periods compared to fully vaccinated children (median absence: 14 versus 10 days; p-value = 0.05). Multivariable regression showed that full COVID-19 vaccination was associated with fewer days of absence compared to no/partial vaccination on average (adjusted relative risk: 0.77; 95 % CI: 0.61 to 0.98). COVID-19 VE was 50.7 % (95 % CI: −11.3 % to 78.2 %) for school absenteeism above the median duration of absenteeism. ConclusionsFull COVID-19 vaccination conferred protection against school absenteeism in hospitalized school-aged children with COVID-19.

Challenges in Enhancing Letter-Name Knowledge Acquisition for Public Pre-Primary Children in Shinyanga Region

Letter Name Knowledge is among the most vital emergent literacy skills that predict future reading and writing among pre-primary children, and teachers are central to learning. Much has been researched on the factors influencing letter name acquisition, including the child's characteristics in the home and school environment. Less research has been done on pre-primary teachers’ views on the factors they encounter in enhancing letter name skills in children. This study investigated pre-primary teachers' challenges in enhancing letter-name knowledge among pre-primary learners in the Shinyanga District Council, Shinyanga Region. The study identified challenges pre-primary teachers encounter in enhancing letter-name knowledge. The study also assessed the challenges pre-primary teachers face in enhancing the knowledge of letter names for pre-primary children with the guidance of the Whole-Child Approach. A qualitative approach and phenomenological design were utilised for the study.20 (to the point of saturation) pre-primary teachers were involved in the interview for data collection. The obtained data were analyzed thematically. The findings identified the following challenges: pre-primary children’s use of mother tongue, inadequate teaching and learning facilities and instructional materials, lack of teachers’ professionalism, large class size and instructional burden, children absenteeism and implementation of pre-primary curriculum. In conclusion, the identified challenges influence pre-primary teachers' effectiveness in enhancing letter name knowledge acquisition for public pre-primary children in the Shinyanga region. The study recommends that the Ministry of Science and Technology (MoEST) create a mother tongue policy for pre-primary children for quality, fair and holistic comprehensive curricula provision in rural areas.

Heterogeneity in the household experiences of young children in head start and associations with absenteeism

Understanding who is absent and what levers may reduce absenteeism is important for promoting not only children's attendance at school but also their learning and development across the school year. The absenteeism literature has primarily focused on socioeconomic status as a key predictor of absenteeism, which ignores the heterogeneity in the lived experiences of children from low-income households that are relevant for their absenteeism. Within a nationally representative sample of children enrolled in Head Start (N = 2,439), this study used latent profile analysis to understand whether and how patterns of household factors predicted children's absenteeism, as well as for whom two school-home connection factors may be more versus less salient levers for reducing absenteeism. Five household profiles emerged in this sample of children enrolled in Head Start. These combinations meaningfully predicted absenteeism above and beyond household income alone. Moreover, parents’ satisfaction with Head Start and programs’ provision of family support services were negatively associated with children's absenteeism, and these associations did not vary by profile. These findings highlight the importance of examining the heterogeneity in the types and combinations of household characteristics children may experience and point to school-home connections as an important focus area for programs.

Intervention for school anxiety and absenteeism in children (ISAAC): Co-designing a brief parent-focused intervention for emotionally-based school avoidance.

Emotionally-based school avoidance (EBSA) is an important driver of persistent school absenteeism and may have worsened in the context of COVID-19. This paper describes the development of a brief parent-focused psychosocial intervention with the goal to address the lack of accessible early interventions for EBSA. The developmental process used a person-based approach with two phases. In Phase 1, qualitative data were collected about intervention preferences and priorities from N = 10 parents and N = 7 practitioners in a series of co-design workshops. Phase 2 refined an intervention blueprint based on iterative consultations with N = 4 parents and N = 3 practitioners. Framework analysis was used to organise findings around key intervention parameters, including relevant mechanisms, content, and delivery methods needed to provide effective, acceptable and feasible support for families affected by EBSA. The resulting blueprint incorporates three online modules to be delivered over three weeks with each module consisting of psychoeducational videos, self-completed learning tasks and a corresponding coaching session. Respective module content includes: (i) self-care strategies to increase parent wellbeing and self-efficacy; (ii) parenting strategies to change behavioural patterns that maintain child distress and avoidance of school; and (iii) strategic communication strategies to increase the quality of home-school relationships. The blueprint has been developed into a full prototype for a forthcoming feasibility study.

School absenteeism in children with special health care needs. Results from the prospective cohort study ikidS.

Children with special health care needs (SHCN) due to a chronic health condition perform more poorly at school compared to their classmates. There is still little knowledge on the causal pathways and which factors could be targeted by interventions. We, therefore, investigated school absenteeism in children with SHCN compared to their peers. This study was based on data from the German population-based prospective cohort study ikidS (German for: I will start school). Children with SHCN were identified by the Children with Special Health Care Needs screener that captures five consequences of physical or mental chronic health conditions: (1) use or need of prescription medication, (2) above average use or need of medical, mental health, or educational services, (3) functional limitations compared with others of the same age, (4) use or need of specialized therapies, and (5) treatment or counseling for emotional, behavioral, or developmental problems. School absenteeism was defined as days absent from school due to illness during first grade and was reported by classroom teachers. Associations between SHCN consequences and school absenteeism were investigated by negative binomial regression models. Effect estimates were adjusted for confounding variables identified by a causal framework and directed acyclic graphs. 1,921 children (mean age at follow-up 7.3 years, standard deviation 0.3; 49% females) were included; of these, 14% had SHCN. Compared to their classmates, children with SHCN had more days absent (adjusted rate ratio: 1.37; 95% confidence interval 1.16, 1.62). The effect was strongest among children with i) functional limitations, ii) treatment or counseling for emotional, behavioral, or developmental problems, and iii) those who experienced two or more SHCN consequences. Children with SHCN have higher school absenteeism, which could-at least partly-explain their poorer school performance and lower educational attainment. SHCN-specific targeted interventions may reduce the adverse effects of SHCN on educational outcomes in children.

The Effect of Health Insurance Status on School Attendance.

Introduction Educational achievement is impacted by a student's ability to be present and motivated in the classroom. Since health and education influence one another, disparities in health insurance status amongchildren may exert educationally relevant consequences. However, the association between health insurance coverage and school absenteeism remains poorly understood. Our study aims to assess the association between not having/having gaps in health insurance coverage and an increased number of missed school days. Methods A historical cohort study was performed via secondary analysis of data collected as part of the 2018 National Survey of Children's Health (NSCH). We included children enrolled in school between the ages of 6-17 yearsand who provided answers to survey questions involving our two variables of interest: health insurance status and missed school days. Our data analysis included 1) a descriptive analysis of the baseline sample characteristics, 2) a bivariate analysis to determine the association between baseline characteristics/confounding variables and the outcome, and 3) a multivariable regression analysis using logistic regression to determine the association of interest while controlling for potential confounding variables. Results A total of 21,498 respondents were included. The unadjusted odds of chronic absenteeism were found to be 16% (OR=1.16) higher in children without insurance or with gaps in insurance compared to children with consistent insurance throughout the year, but the association was not statistically significant (95% CI 0.74 - 1.82, p=0.051). After adjustment by age, sex, race, Hispanic ethnicity,and confounding variables, the odds of chronic absenteeism in children without insurance or with gaps in insurance remained statistically insignificant (aOR=1.05; 95% CI 0.64 - 1.73, p=0.848) compared to those with consistent insurance coverage. Conclusions According to our analysis, the data do not support our hypothesis of a significant difference in missed school days (greater than or equal to 11 missed days of school) among those children who had health insurance compared to those without health insurance/had gaps in insurance coverage.

Children's absenteeism from pre-K to kindergarten: A focus on children receiving child care subsidies

As many as 48% of children in prekindergarten (pre-K) miss a month or more of the pre-K year (i.e., 10% or more of the school year), and high levels of absenteeism are associated with adverse academic and social-emotional outcomes in pre-K and in K-12. To date, no studies have examined absenteeism specifically among children receiving child care subsidies, a population of children who may be at greater risk for high absenteeism. Moreover, few studies have explored absenteeism in diverse early care and education (ECE) programs beyond public school pre-K or Head Start programs. This study uses administrative data from Massachusetts to address these gaps by (1) documenting absenteeism rates for children receiving subsidies during the pre-K year in both family child care (FCC) and center-based care (CBC) programs and in kindergarten; and (2) testing whether pre-K absenteeism is associated with kindergarten absenteeism in the full sample and by ECE program type. Results show that children enrolled in subsidized care were absent for an average 8.4% of the school year in pre-K and 5.9% of the school year in kindergarten. Absenteeism rates were lower in pre-K but slightly higher in kindergarten among children enrolled in FCCs, compared to those enrolled in CBCs (Pre-K: 7.2 versus 8.7%; Kindergarten: 6.2 vs 5.8%, respectively). Results from multilevel regression analyses showed that the associations between pre-K and kindergarten absenteeism were positive for children enrolled in both CBC and FCC programs. By documenting the prevalence of absenteeism among a sample of children receiving child care subsidies in diverse ECE programs, this study provides implications for ECE and child care subsidy research, policy, and practice.

Novel care pathway to optimise antimicrobial prescribing for uncomplicated community-acquired pneumonia: study protocol for a prospective before–after cohort study in the emergency department of a tertiary care Canadian children’s hospital

IntroductionEvidence-based recommendations for paediatric community-acquired pneumonia (CAP) diagnosis and management are needed. Uncomplicated CAP is often caused by respiratory viruses, especially in younger children; these episodes self-resolve without antibiotic treatment....

Patient- and caregiver-reported factors associated with school absenteeism in children with chronic kidney disease.

BackgroundChildren with chronic kidney disease (CKD) are at risk for neurocognitive deficits while simultaneously being at risk for chronic school absenteeism (≥ 18 school days per school year). Chronic school absenteeism compounds the negative impacts of CKD on academic achievement. In this study, we examined patient- and caregiver-reported factors associated with school absenteeism in children with non-dialysis- or transplant-dependent CKD in order to help identify which factors could be modifiable and ultimately improve school attendance.MethodsWe utilized a combination of chart review and questionnaires distributed in person to patients and caregivers at a pediatric nephrology clinic between November 2018 and August 2019 to gather data. We used descriptive statistics to illustrate clinical characteristics of the children included in the study, caregiver characteristics, and examined reported reasons for missing school.ResultsTwenty-one percent of participants (10/48) missed 18 full days of school or more, categorizing them as chronically absent. The top three reasons for missing school were doctor appointments, feeling sick, and being bullied. More specific sequelae of CKD were not highly reported as reasons for missing school.ConclusionsChronic absenteeism is a highly reported phenomenon among children with pediatric CKD. Given that missing school for doctor appointments was a top reason for absenteeism, this data suggests alternative appointment hours and virtual appointments may reduce chronic school absenteeism in children, and by extension improve their health, behavioral, and academic outcomes.Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary informationSupplementary InformationThe online version contains supplementary material available at 10.1007/s00467-022-05780-2.

EFFECTIVENESS OF FAMILY EMPOWERMENT EDUCATION ON SCHOOL ABSENTEEISM IN CHILDREN WITH ASTHMA: A RANDOMIZED CONTROLLED TRIAL

TYPE: Late Breaking Abstract TOPIC: Allergy and Airway PURPOSE: This study aimed to assess the effect of a family empowerment intervention on school absenteeism in children with asthma. METHODS: A monocentric study using a randomized controlled design was conducted in the pediatric outpatient clinic of Farhat Hached University Hospital from May 2018 to September 2019. Eighty-two families were randomly assigned in the intervention group (n=41) of eight weeks of group training sessions or to a control group (n=41) of usual care education. Thirty-seven families in the intervention group and 39 families in the control group received allocated intervention at baseline. Thirty-four families in each group completed the study at the 12-month follow-up. RESULTS: At baseline, there was no significant difference between the intervention and the control group in term of sociodemographic data. The results showed that the number of children who had missed school days was reduced at follow-up in the intervention and the control group with a significant difference within time (p= 10⁻³; p=10⁻³, respectively). However, there was no significant difference between groups at baseline and follow-up (p=0.7; p=0.3, respectively) CONCLUSIONS: This study suggested that family empowerment education with group discussion sessions and feedback can reduce missed school days in children aged 7 to 17 years with mild to moderate asthma. CLINICAL IMPLICATIONS: This study suggested that family empowerment education with group discussion sessions and feedback can reduce missed school days in children aged 7 to 17 years with mild to moderate asthma. DISCLOSURE: No significant relationships. KEYWORD: Asthma

Antibiotic use and impact on illness course in children with influenza-like-illness in the emergency department

Background: Child absenteeism from childcare or school leads to economic loss from parental work absenteeism, overutilization of acute-care resources, and excess medicalization of children with minor illnesses. We sought to determine the difference in days missed from childcare or school and days of illness for children with influenza-like illness (ILI) in the emergency department (ED) who are or are not prescribed an antibiotic. Methods: We conducted a secondary data analysis of a prospective randomized control trial evaluating the impact of rapid molecular testing on provider decision making. The study included children aged 2 months–12 years attending childcare or school seen in the ED from December 2018 through December 2019 with ILI (CDC definition) with parental survey completion 10 days after their ED visit. The primary exposure was receipt of antibiotics over the course of illness, which was assessed by chart review and parent survey. The primary outcome was number of days missed from class. The secondary outcome was number of days of illness after initial ED visit. Wilcoxon tests were used to compare missed class days or illness days by antibiotic receipt. Multivariable negative binomial regression was used to analyze outcomes, controlling for clinically important patient characteristics. Results: Of 251 children included in this study, the median age was 4.2 years (IQR, 1.6–7.0); 52% were male, 40% were White, 54% were Hispanic, and 75% had government insurance. Antibiotics were prescribed in 26% of ILI encounters. There was no statistically significant association between antibiotic receipt and number missed class days (2.0 days [IQR, 1.0–4.0] vs 3.0 days [IQR, 1.0–5.0]; P = .08) or illness days (4.0 days [IQR, 3.0–7.0] vs 5.0 days [IQR, 3.0–7.0]; P = .13) after the initial ED visit. After adjusting for covariates, there was no significant difference in missed class days or illness days for patients prescribed antibiotics in relation to days sick before ED visit. The rates of missed class days and illness days were 87% and 30% greater, respectively, in patients with additional medical visits during the course of illness. Conclusions: Days sick prior to ED presentation and receipt of an antibiotic for ILI had no influence on child absenteeism or illness duration. However, children missed more class and received more antibiotics if they had multiple medical visits during an illness. Further study is needed on sociobehavioral factors leading to medicalization of children with minor illnesses and its impact on the unnecessary use of antibiotics.Funding: NoneDisclosures: None

Mental health and school absenteeism in children with long-term physical conditions: A secondary analysis of the British Child and Adolescent Mental Health Surveys 2004 and 2007.

Children and young people (CYP) with long-term physical conditions (LTCs) are more likely to have poorer mental health and more school absenteeism compared with CYP with no LTCs. However, there is limited longitudinal research, and the extent to which these difficulties persist in CYP with LTCs is unknown. Furthermore, little is known about the relative impact of different types of LTC on mental health and absenteeism. We investigated cross-sectional and longitudinal associations of different LTCs with mental health and school absenteeism in a large (N=7977) nationally representative survey of CYP in Great Britain and its 3-year follow-up. Psychopathology was assessed using the parent-reported Strengths and Difficulties Questionnaire (SDQ), and diagnosis of any psychiatric disorder using the Development and Wellbeing Assessment (DAWBA). Days absent and persistent absence (missing 10% or more of school days) were reported by parents. Compared with those with no LTCs, CYP with any LTC had higher SDQ total difficulties scores at baseline (adjusted mean difference 1.4, 1.1-1.6) and follow-up (1.1, 0.8-1.4) and were more likely to have a psychiatric disorder at baseline (adjusted odds ratio [aOR] 1.59, 1.34-1.89) and follow-up (1.75, 1.44-2.12). Children with any LTC also missed more days of school at baseline (adjusted incidence rate ratio 1.47, 1.31-1.64) and follow-up (1.17, 1.00-1.36) and were more likely to be persistently absent (aOR baseline 1.78, 1.48-2.14; follow-up 1.27, 1.00-1.61). Neurodevelopmental disorders, migraines and atopic conditions were particularly strongly associated with both mental health and absenteeism. Children with LTCs had poorer mental health and more school absence than those with no LTCs. Clinicians should routinely enquire about mental health and school attendance in CYP with LTCs and should collaborate with families and schools to ensure these children are provided with sufficient mental health and educational support.

Association of pediatric atopic dermatitis and psoriasis with school absenteeism and parental work absenteeism: A cross-sectional United States population-based study

The impact of childhood atopic dermatitis (AD) and psoriasis on school absenteeism is not fully elucidated. To determine the burden and predictors of chronic school absenteeism in children with AD and psoriasis. Data were analyzed from the 1999-2015 Medical Expenditure Panel Surveys, cross-sectional, population-based studies of health status and function in the United States. Among 3132 and 200 children with AD and psoriasis, respectively, 1544 (67.7%) and 97 (62.5%) missed ≥1day, and 120 (3.9%) and 5 (3.6%) missed ≥15days (chronically absent) per year due to illness. AD was associated with chronic absenteeism overall (logistic regression; adjusted odds ratio 1.42, 95% CI [1.13-1.78]) and with more severe disease (mild-moderate: 1.33 [1.04-1.70], severe: 2.00 [1.21-3.32]). No statistical difference in chronic absenteeism was found for children with versus those without psoriasis (1.26 [0.51-3.12]). Parents of children with AD were more likely to miss work for caregiving versus those of children without AD, whereas parents of children with psoriasis had similar rates of work absenteeism versus those of children without psoriasis. The severity of AD and psoriasis was assessed by treatment pattern. Children in the United States with AD had increased chronic school absenteeism. Further interventions are warranted to prevent school absenteeism in childhood AD.

517: School and Work Absenteeism in Children With Acute Respiratory Failure and Their Families

517: School and Work Absenteeism in Children With Acute Respiratory Failure and Their Families

Pre- and postoperative quality of life and emotional/behavioural problems in children with PFAPA

ObjectiveThis study aimed to evaluate the effects of surgical intervention on quality of life, emotional/behavioural problems and school absenteeism in children with periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA.) MethodA total of 56 children aged between 4 and 12 years, diagnosed with PFAPA and undergoing tonsillectomy with/without adenoidectomy at a tertiary hospital were included in the study. The Questionnaire for Quality of Life Assessment for Children and Adolescents Parent Form (Kid-KINDL) and the Strengths and Difficulties Questionnaires (SDQ) were used to evaluate quality of life and emotional/behavioural problems, respectively. The cases were assessed before and three months after surgery. ResultsThe mean (SD) age of the children was 6.64 (3.03) years, and 58.9% (n = 33) were boys. The numbers of pre- and post-operative periodic fever episodes were 3.0 (1.7) and 0.6 (0.9) (p < 0.001), those for school absenteeism were 10.28 (5.53) and 2.85 (2.95) days (p < 0.001) and those for hospital presentations were 3.8 (2.5) and 1.1 (1.1) (p < 0.001), respectively, all of which were significantly lower in children with PFAPA at three months after the operation. The surgical procedures were effective in improving quality of life and emotional/behavioural problems, as evidenced by the significant differences between the pre- and post-treatment scores in outcome measures, including SDQ and Kid-KINDL (p < 0.001). ConclusionsThis study demonstrated that the surgical approach exhibited positive effects in terms of improving quality of life and reducing emotional/behavioural problems and school absenteeism in children with PFAPA.

School Refusal or Truancy? A Qualitative Study of Misconceptions Among School Personnel About Absenteeism of Children From Immigrant Families

BackgroundSchool refusal is a form of school attendance problem (SAP) distinct from truancy, school withdrawal, and school exclusion; it requires specific mental health care. Schools' identification and referral to care of school refusers depends on school personnel's interpretation of the reasons for absences. Because cultural factors can induce misunderstanding of the young people's behavior and of their parents' attitudes toward school attendance, school personnel can have difficulty understanding these reasons for children with transcultural backgrounds (migrants or children of migrants). The aim of this study was to explore the experiences and opinions of school personnel, mainly teachers, related to school refusal among these students.MethodsGrounded theory methodology was used to conduct 52 qualitative interviews of school personnel in two regions of France. Their daily practices with students presenting with school refusal were addressed in general (i.e., in response to absence of all youth) and in transcultural contexts (i.e., absence of migrant children or children of migrants). This study analyzed the interviews of the 30 participants who reported working with students from transcultural backgrounds.ResultsMany school personnel reported experiencing difficulties, ambivalence, and destabilizing feelings in situations involving immigrant families whose school culture differed from their own. Talking about culture appeared to be taboo for most participants. These situations challenged the participants' usual strategies and forced them to devise new ones to deal with these young people and their families. Although some personnel were at risk of developing exclusionary attitudes, others dealt with school refusal with both commitment and creativity.ConclusionThe tensions experienced by these participants reveal contradictions between the French universalist ideology and the reality of daily life in schools becoming increasingly multicultural. School personnel's attitudes toward children with transcultural backgrounds presenting with school refusal can affect children's access to care and shape social inequalities. Further research should develop, implement, and assess interventions including transcultural training of school personnel, improved use of interpreters at school for migrant families, and the addition of a transcultural dimension to SAP assessment scales, especially for school refusal.

Impact of perinatal and repeated maternal common mental disorders on educational outcomes of primary school children in rural Ethiopia: population-based cohort study.

There have been no studies from low- or middle-income countries to investigate the long-term impact of perinatal common mental disorders (CMD) on child educational outcomes. To test the hypothesis that exposure to antenatal and postnatal maternal CMD would be associated independently with adverse child educational outcomes in a rural Ethiopian. A population-based birth cohort was established in 2005/2006. Inclusion criteria were: age between 15 and 49 years, ability to speak Amharic, in the third trimester of pregnancy and resident of the health demographic surveillance site. One antenatal and nine postnatal maternal CMD assessments were conducted using a self-reporting questionnaire, validated for the local use. Child educational outcomes were obtained from the mother at T1 (2013/2014 academic year; mean age 8.5 years) and from school records at T2 (2014/2015 academic year; mean age 9.3 years). Antenatal CMD (risk ratio (RR) = 1.06, 95% CI 1.05-1.07) and postnatal CMD (RR = 1.07, 95% CI 1.06-1.09) were significantly associated with child absenteeism at T2. Exposure to repeatedly high maternal CMD scores in the preschool period was not associated with absenteeism after adjusting for antenatal and postnatal CMD. Non-enrolment at T1 (odds ratio 0.75, 95% CI 0.62-0.92) was significantly but inversely associated with postnatal maternal CMD. There was no association between maternal CMD and child academic achievement or drop-out. Our findings support the hypothesis of a critical period for exposure to maternal CMD for adverse child outcomes and indicate that programmes to enhance regular school attendance in low-income countries need to address perinatal maternal CMD. None.