Illness-related absence among preschool children: Insights from a health intervention in Swedish preschools

We evaluate the effect of a preschool health intervention aimed at reducing infections through improved hygiene practices and training of the staff. The large-scale design enables us to study heterogeneous effects with respect to several child and preschool characteristics that are related to the level of illness-related absence. We find no reduction, on average, in children's illness-related absence. This conclusion holds across different age groups of preschool children, and for preschools with varying levels of absence before the intervention. We find some suggestive evidence that the intervention may have induced effects operating in different directions: while improved hygiene practices may have reduced illness, stricter guidelines regarding absence during infections seems to have contributed to an increased absence level, resulting in an overall zero effect. Overall, our results suggest that reducing absence through improved hygiene practices is not easily accomplished in a child care setting.