Illness-related school absenteeism among children attending a primary healthcare facility: Socio-demographic and clinical correlates in Ho municipality, Ghana.

Objectives: Illness among school-age children who seek clinical care can disrupt their school attendance, yet the socio-demographic and clinical factors driving this in Ghana remain poorly understood. This study examined the socio-demographic and clinical correlates of illness-related school absenteeism among children aged 5-17 years attending a general outpatient polyclinic in the Ho Municipality, Ghana. Study design: A facility-based prospective longitudinal study design was employed. Methods: The study included 644 children aged 5-17 years who visited the Ho Polyclinic with illness conditions during a six months review period. A consecutive sampling approach of eligible clinic attendees was used to recruit participants. Data were collected using a pre-tested structured questionnaire and clinical assessments, including routine laboratory investigations. Follow-up was conducted for two weeks after the initial clinic visit, with caregivers contacted by phone or in person, to capture the total number of school days missed due to the illness episode. Multivariable logistic regression analysis (p < 0.05) was used to identify the socio-demographic and clinical factors associated with illness-related school absenteeism. Results: Overall, 66.3% of the children missed school due to illness. Children aged 10-13 years [aOR = 1.63 (95% CI: 1.04-2.54), p = 0.032] and 14-17 years [aOR = 2.51 (95% CI: 1.24-5.09), p = 0.011] had significantly higher odds of absenteeism than those aged 5-9 years, while children in junior high school [aOR = 0.41 (95% CI: 0.26-0.64), p < 0.001] and senior high school [aOR = 0.28 (95% CI: 0.13-0.62), p = 0.002] had significantly lower odds than those in primary school. Clinically, chills [aOR = 1.87 (95% CI: 1.19-2.93), p = 0.007], abdominal pain [aOR = 1.69 (95% CI: 1.12-2.56), p = 0.012], and skin rashes [aOR = 1.91 (95% CI: 1.30-2.80), p = 0.001] were significantly associated with illness-related school absenteeism after adjustment for socio-demographic factors and diagnosis; fever, cough, vomiting, and headache were not significant once symptom inter-correlation was accounted for. Conclusions: Illness-related school absenteeism among children presenting for care at Ho Polyclinic is common and is associated with both socio-demographic characteristics and acute clinical symptoms. Strengthening school health services and improving early management of common childhood illnesses may help reduce school absenteeism among care-seeking children.