Schoolchildren are called in sick more often than previously thought

Esther Pijl

Schoolchildren are called in sick more often than previously thought

The societal impact of UM research

15-04-2024 · Interview

In today’s world, the societal impact of research findings seems more important than getting published in an academic journal like Nature or The Lancet. What impact has research conducted at UM had in recent years? This week: a study on the prevalence of sickness absence among primary school pupils, eagerly anticipated by public health services across the country.

Dylan (7) has already missed several days of school this year. His parents often call him in sick with headaches or stomach aches, and sometimes the flu. The boy is struggling in school, falling behind more with each absence. His teacher is concerned about him. What’s going on with Dylan?

The school invites Dylan’s parents in to discuss the situation. Together, they decide to seek assistance from Esther Pijl, a PhD candidate at Maastricht University and child and youth healthcare physician at the Regional Public Health Service (GGD) West-Brabant.

Pijl performs a physical exam and assesses Dylan’s family situation. “From speaking with the parents and the child, I learnt that the family is under a lot of stress. Dylan’s father is dealing with mental health issues, and his parents’ relationship has been strained for quite some time. It literally makes Dylan feel sick to his stomach.”


Pijl recently earned her PhD for her research, which revealed that the prevalence of sickness absence among primary school pupils in the Netherlands is higher than previously thought. Through interviews and focus groups with parents and teachers across fourteen schools in West Brabant, she found that an average of 13 per cent of children showed “extensive sickness absence”. Extensive sickness absence is defined as more than nine school days or four periods of sickness absence per year, whereas one or two times per year is considered typical.

Though Pijl focused on primary schools in West Brabant, extensive sickness absence appears to be a wider problem. She found similar figures in South Limburg. “The extent of the problem is difficult to determine. There’s been very little research on this, both nationally and internationally. There has been research on truancy, but truancy is nearly non-existent in primary schools.”

Sickness absence among primary school pupils has a range of causes, explains Pijl. “Chronic illnesses like asthma, symptoms of depression, bullying, problems at home, and usually a combination of these factors. Interestingly, teachers often attribute it to problems at home, while parents point to problems at school. The sooner the school and the parents sit down together, the better.”

Family situation

Pijl tested a step-by-step guide that had already proved effective in secondary schools. A few years ago, there was concern about the high rates of sickness absence among secondary school students in the Netherlands. This prompted the development of an intervention called MASS (Medical Advice for Sick-Reported Students), which had a significant positive impact in both secondary and vocational education.

The first step of MASS is keeping a register of absence for all children. “Failing to do so leads to blind spots. You might overlook children in families where you wouldn’t expect this problem. Next, teachers and special needs coordinators – often former teachers – discuss what they know about the child and their parents. Special needs coordinators often have a bit more insight into the family situation.”

Then, in step three, the teachers and parents sit down together, with or without the child, to see if the problem can be resolved without involving external experts. “In secondary schools, this would be a child and youth healthcare physician. In primary schools, it could be a social worker or a remedial educationalist. They’ll design a plan of action.”

National interest

Pijl concluded that the MASS intervention is also effective in primary schools. It helps to identify pupils who would otherwise slip under the radar. Specifically, her research showed that children with extensive sickness absence miss fewer school days at schools using MASS.

These findings haven’t gone unnoticed. Six Regional Public Health Services (GGD) locations have expressed interest in MASS and are currently implementing it in primary schools. They serve as central points of contact in their regions, sharing information about MASS with municipalities and schools. The Ministry of Education, eager to reduce school absenteeism, has also expressed interest.

Pijl’s research also revealed that few primary school pupils are currently being referred to child and youth healthcare physicians. This, she says, is why it’s important to raise awareness among school professionals about the benefits of seeking medical advice. “It’s in the interest of the child’s well-being.”

Photo: Dolph Cantrijn

Categories: news_top, Science
Tags: impact,societal,school,children,health servives,ggd,sickness,absence,primary school,mass,research,instagram

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