The study was aimed to assess the relationship of general health and cognitive function of primary school children in Pakistan.

Prospective observational study conducted in 2 state and 2 private schools in a small district.

Two hundred children age 7-12 years class 3, 4 and 5 were assessed using McCarthy scale of child cognition. 11(5.5%) children stated missing some immunization whereas 15(7.5%) found to have recurrent health issues.

Healthy children demonstrated better verbal and linguistic skills. (Mean score 3.94 ± 0.85 vs 3.27 ± 1.03, P = 0.004).Similarly children receiving full immunization demonstrated better verbal and linguistic skills (score 3.91 ± 0.87 vs 3.18 ± 0.87, P = 0.01).

Mathematical ability was assessed by 3 tests and was scored 1–3. Children with no recurrent health issues demonstrated better mathematical ability (2.56±0.62 vs. 1.93± 0.70, P=< 0.000). Similarly children compliant with immunization demonstrated better mathematical ability (P = 0.02).

Reasoning in conversation was assessed on scale of 1-7. Immunization compliant group expressed better reasoning score (P = 0.03).There was no statistical difference between the group with recurrent health issues and the healthy group (P = 0.51).

Memory was assessed on a scale of 1–4. Better memory was observed in the immunization compliant group (P = 0.006) whereas no significant difference observed between the healthy group and the group with recurrent health issues (P = 0.51).

Gross movements were assessed on a scale of 1–5. The Immunisation compliant and the healthy group demonstrated better performance (P = 0.03 and 0.07) respectively.

This study demonstrates that missing immunisation and recurrent health problems result in poor cognitive function and school performance.