以「兒童蓬勃指數」評估台灣兒童健康福祉之現況

Evaluation of children’s well-being in Taiwan by using the Child Flourishing Index

目標：WHO-UNICEF-Lancet委員會於2020年提出「兒童蓬勃指數」（Child Flourishing Index, CFI），作為評估各國兒童健康福祉之新國際指標，該指標之各國評比未納入我國，因此本研究旨在計算台灣之分數，了解我國兒童健康福祉現況。方法：本研究依照「兒童蓬勃指數」之方法學，採用聯合國SDGs資料庫、「健康指標與評估研究所」（IHME）資料及我國政府統計資料，計算出我國「兒童蓬勃指數」。結果：「兒童蓬勃指數」分數介於0-1間，台灣2017年總分為0.9分，全球排第24名。生存維度應改善的指標有2項，包括「孕產婦死亡率」、「0-19歲道路傷害死亡率」。 茁壯維度中3項指標可加強，即「低出生體重率」、「5歲以下兒童發展遲緩盛行率」、「18-29歲民眾在18歲以前受過性別暴力的比例」。我國的環境永續指標，碳排嚴重超量344%，公平性指標吉尼指數為31.5。結論：「兒童蓬勃指數」是結合永續發展、兒童權利、性別平等、世代正義之新指標，可檢視我國政策友善兒童健康福祉的程度， 作為政策改善的實證基礎。本研究建議強化我國兒少統計專區中，補充兒童指標數據之完整性，並藉由跨部會合作，將兒童納入所有政策，改善兒童健康福祉。

Objectives: In 2020, the WHO–UNICEF–Lancet Commission developed the Child Flourishing Index (CFI) to evaluate the health and well-being of children in different countries. In the current study, we used this index to evaluate the health and well-being of children in Taiwan, who are not currently considered in the CFI. Methods: In accordance with the original CFI methodology, we calculated the CFI in Taiwan by using data obtained from the Sustainable Development Goals, Institute for Health Metrics and Evaluation, and official statistics of Taiwan. Results: CFI scores range from 0 to 1, Taiwan’s CFI score in 2017 was 0.9, indicating Taiwan had the 24th highest score in the world. The results in the survival domain of the CFI indicated that Taiwan should focus on improving the rate of maternal mortality and the rate of road injury mortality among individuals aged 0–19 years. The results for the thriving domain indicated that Taiwan should also focus on improving the rate of low-weight births, the prevalence of stunting among children younger than 5 years, and the proportion of young men and women aged 19–29 years who experience sexual violence before the age of 18 years. The results for sustainability indicated that Taiwan should reduce its carbon emissions, which reached 344%, and that the Gini index value for income inequity in Taiwan was 31.5. Conclusions: The CFI can be used as an index of sustainable development, child rights, gender equality, and generational justice to evaluate the child-friendliness of Taiwanese policies. We suggest that child-related indicators be improved and that cross-departmental collaborators be encouraged to include children in policies to improve child health and well-being in Taiwan.