Sabah survey finds major gaps in child wellbeing despite near-universal healthcare access

KOTA KINABALU, June 5 — A new survey has found significant gaps in child wellbeing in Sabah across health, learning, nutrition, food security and safety, despite high levels of access to basic services such as healthcare and schooling.

The Sabah Child Wellbeing Index (SCWI) 2026 showed that while most children can access services, far fewer meet minimum wellbeing benchmarks across key development areas.

The index found that only 55.9 per cent of children met the overall health wellbeing benchmark, despite 92.3 per cent having access to healthcare services.

Health wellbeing gap despite high access to healthcare services

The SCWI measures whether children meet minimum standards across indicators including immunisation, nutrition and age-specific health outcomes.

Only 73.6 per cent of children were fully immunised by 23 months, meaning nearly one in four had not completed the recommended vaccination schedule.

Health outcomes were strongest among children aged five and below, but declined sharply among older age groups, with only 20.8 per cent of adolescents aged 13 to 17 meeting the health benchmark.

The decline was particularly evident in sexual and reproductive health, where only 31.8 per cent of adolescents aged 15 to 17 met the benchmark.

Regional disparities within the state were also evident, with Tawau recording the lowest proportion of children meeting the health benchmark at 45.9 per cent, compared with 70.8 per cent in the Interior division.

The report attributed the gaps to factors including geography, transport challenges and uneven access to services.

Disparities were significantly more pronounced among vulnerable groups, with only 27.7 per cent of children with disabilities meeting the health benchmark, and just 0.6 per cent among undocumented and stateless children.

Food insecurity affects three-quarters of children

In nutrition and development, 30.6 per cent of children met the threshold for adequate nutrition and development checks.

The report noted this aligns with national health findings showing a significant proportion of children in Sabah are underweight or stunted.

Food insecurity remains a major concern, with 28.2 per cent of children classified as food secure, suggesting that about three-quarters experience some level of food insecurity.

Learning outcomes lag despite high school participation

Under the learning domain, only 27.2 per cent of children met the overall learning benchmark, which measures school participation, access to learning resources and educational outcomes.

While school attendance remains relatively high, only 34.6 per cent of children met the benchmark for access to information and learning resources.

Educational outcomes were highest among children aged five and below at 41.8 per cent, but dropped to 26.6 per cent in primary school and 20.3 per cent in secondary school.

More than 97 per cent of adolescents said education was important for their future, but only 75.6 per cent were on track to complete school, indicating structural rather than motivational barriers to learning.

Outcomes were significantly lower among vulnerable groups, with only 8.2 per cent of children with disabilities and 2.7 per cent of undocumented and stateless children meeting the learning benchmark.

Safety and protection remain the weakest domain

The safety and protection domain recorded the lowest outcomes overall, with only 6.1 per cent of children meeting minimum standards.

This domain covers housing conditions, exposure to violence, environmental safety and protection from bullying and harm.

Only 41.4 per cent of children were found to have adequate housing conditions.

The report highlighted safety as the most critical gap, indicating widespread exposure to risks affecting children’s wellbeing.

The SCWI was developed through a collaboration between Unicef Malaysia and the Sabah State Economic Planning Unit (Upen), covering 4,441 children out of an estimated 1.07 million in Sabah.

The report recommends strengthening health and nutrition services, expanding inclusive education access, improving housing and child protection systems, and using data-driven policymaking to address disparities.