Guyant et al. Malar J (2015) 14:252
DOI 10.1186/s12936-015-0773-5
RESEARCH
Malaria and the mobile and migrant
population in Cambodia: a population
movement framework to inform strategies
for malaria control and elimination
Philippe Guyant
1,4*†
, Sara E Canavati
2,5†
, Nguon Chea
3
, Po Ly
3
, Maxine Anne Whittaker
6
, Arantxa Roca-Feltrer
2
and Shunmay Yeung
1
Abstract
Background: The relationships between human population movement (HPM) and health are a concern at global level. In
the case of malaria, those links are crucial in relation to the spread of drug resistant parasites and to the elimination of malaria
in the Greater Mekong sub-Region (GMS) and beyond. The mobile and migrant populations (MMP) who are involved in forest
related activities are both at high risk of being infected with malaria and at risk of receiving late and sub-standard treatment
due to poor access to health services. In Cambodia, in 2012, the National Malaria Control Programme (NMCP) identified, as a
key objective, the development of a specific strategy for MMPs in order to address these challenges. A population movement
framework (PMF) for malaria was developed and operationalized in order to contribute to this strategy.
Methods: A review of the published and unpublished literature was conducted. Based on a synthesis of the results,
information was presented and discussed with experienced researchers and programme managers in the Cambo-
dian NMCP and led to the development and refinement of a PMF for malaria. The framework was “tested” for face and
content validity with national experts through a workshop approach.
Results: In the literature, HPM has been described using various spatial and temporal dimensions both in the context
of the spread of anti-malarial drug resistance, and in the context of malaria elimination and previous classifications
have categorized MMPs in Cambodia and the GMS through using a number of different criteria. Building on these
previous models, the PMF was developed and then refined and populated with in-depth information relevant to
Cambodia collected from social science research and field experiences in Cambodia. The framework comprises of the
PMF itself, MMP activity profiles and a Malaria Risk Index which is a summation of three related indices: a vulnerability
index, an exposure index and an access index which allow a qualitative ranking of malaria risk in the MMP population.
Application of currently available data to the framework illustrates that the highest risk population are those highly
mobile populations engaged in forest work.
Conclusion: This paper describes the process of defining MMPs in Cambodia, identifying the different activities and
related risks to appropriately target and tailor interventions to the highest risk groups. The framework has been used
to develop more targeted behaviour change and outreach interventions for MMPs in Cambodia and its utility and
effectiveness will be evaluated as part of those interventions.
Keywords: Framework, Migrants, Mobile populations, Cambodia, Artemisinin resistance, Malaria elimination,
Strategy, Index
© 2015 Guyant et al. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License
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Open Access
*Correspondence: philippe.guyant@gmail.com
†
Philippe Guyant and Sara E Canavati contributed equally to this work
1
Department of Global Health and Development, Malaria Centre, London
School of Hygiene and Tropical Medicine, London, UK
Full list of author information is available at the end of the article