This inter-sectoralstudy on education and health was carried out to understand the relative importance of factors other than school, such as health, nutritional status and other personal characteristics of children, and their home background, in determining the level of achievement of primary school students in Sri Lanka. It builds on a study on ‘National Assessment of Grade 4 Pupils in Sri Lanka,’ conducted by the National Education Research and Evaluation Centre (NEREC) of the Faculty of Education, University of Colombo, using a nationally representative sub-sample of children who sat for the NEREC tests in First Language (Sinhala or Tamil), Mathematics and Second Language (English).