The recent UNICEF report ‘Understanding What Shapes Child Well-being in Rich Countries’ (2020) sent shock waves among those working with children and young people in Malta. On the three outcomes of children’s well-being included in the study, out of 38 countries, Maltese children were ranked close to the bottom on mental health (28th), physical health (32nd) and academic and social skills (35th) respectively. Before discussing the results in the report, however, one needs to examine the nature of the report itself and what it actually says.

First of all the report is not based on a specific dataset from a particular project but it puts together findings from other already published reports such as the Programme for International Student Assessment (PISA, OECD), Health Behaviour School Checklist (HBSC, WHO) and the International Subjective Well-being of Children study (ISCWEB), with different instruments, different age groups and different countries put together.

We already knew our low ranking on PISA and that we have the highest rate of obesity in the HBSC study. The ‘new’ findings relate to the clustering of results from various studies and reports on three outcomes; there are issues, however, in what these actually represent, as we shall see below. It is also important to remember with whom we are being compared, namely the rich countries in the world. The report also promotes the idea of a League of Tables (international ranking of countries) as a useful way in improving children’s well-being.

Well-being is situated in context and understandings and meanings of well-being may vary from one sociocultural context to another. International rankings of well-being, therefore, need to be treated cautiously as they may lead to labelling and stigmatisation, particularly if  based on findings that may not be not culturally sensitive.

One of the main issues in this report is the conceptualisation of well-being and, in particular, mental health, physical health and skills.

Meanings of well-being may vary from one sociocultural context to another- Carmel Cefai

Mental health is measured by the rate of suicide in adolescence and one question with 15-year-olds on how satisfied they are with life; there is no indication of level of stress, anxiety or depression, for instance. Physical health indicators include child mortality and obesity and body image; nutrition, physical exercise and substance use, for instance, are not included. Skills outcome is based on students’ performance on academic skills (PISA) and how confident are 15-year-olds in making friends. Social and emotional skills and resilience are not included.

The above outcomes will be more accurate and meaningful, therefore, if they are relabelled as ‘Aspects of...’ For instance, the low ranking on ‘mental health’ is particularly related to the one question on life satisfaction with 15-year-olds in the WHO study (more detailed assessment of this phenomenon in other studies show a more positive picture of Maltese children’s life satisfaction).

The findings in this report, thus, need to be considered in the light of other studies on children’s well-being, both local and international, so that we can have a more robust picture and develop better policy actions for Maltese children. For instance, in the ISCWEB Malta report with eight-, 10- and 12-year-old children published last month by Cefai and Galea, Maltese children appear to enjoy a high level of subjective well-being and rank with the top countries on being satisfied and happy.

We also identified, however, a number of areas where Maltese children are not so happy and would like their well-being to be improved, such as the relative lack of freedom and lack of participation in family decisions, the inadequate play areas and lack of safety in the neighbourhood, not having enough friends, issues with learning, classmates and bullying at school as well as concerns about the future. 

The UNICEF report, however, does raise issues which need to be examined and addressed. The reported finding that social services and programmes contributing to children’s well-being in Malta are below the expected level (in contrast to educational and health systems) is also worth examining in more depth.

The recommendation of a more integrated system of policy actions and support for children’s well-being is a very pertinent one in the local context. Similarly, the recommendation for more voice for children in decisions, with child representatives on boards, councils and projects for children also resonate with various efforts being made in Malta in this regard, including those by the Malta Foundation for the Well-being of Society.

Carmel Cefai for the Malta Foundation for the Well-being of Society.