title: Malaria and the mobile and migrant population in Cambodia: a population movement framework to inform strategies for malaria control and elimination.
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  A review of the published and unpublished literature was conducted.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 Cambodian 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Global Health and Development, Malaria Centre, London School of Hygiene and Tropical Medicine, London, UK. philippe.guyant@gmail.com.|Partners for Development, Phnom Penh, Cambodia. philippe.guyant@gmail.com.
authors.forename: Philippe
authors.initials: P
authors.lastname: Guyant
authors.affiliation: Malaria Consortium, Phnom Penh, Cambodia. s.canavatidelatorre@kellogg.oxon.org.|Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. s.canavatidelatorre@kellogg.oxon.org.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Canavati
authors.affiliation: National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia. cheanguoncnm@gmail.com.
authors.forename: Nguon
authors.initials: N
authors.lastname: Chea
authors.affiliation: National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia. polyteng168@gmail.com.
authors.forename: Po
authors.initials: P
authors.lastname: Ly
authors.affiliation: School of Public Health, University of Queensland, Brisbane, Australia. m.whittaker@uq.edu.au.
authors.forename: Maxine Anne
authors.initials: MA
authors.lastname: Whittaker
authors.affiliation: Malaria Consortium, Phnom Penh, Cambodia. a.roca@malariaconsortium.org.
authors.forename: Arantxa
authors.initials: A
authors.lastname: Roca-Feltrer
authors.affiliation: Department of Global Health and Development, Malaria Centre, London School of Hygiene and Tropical Medicine, London, UK. shunmay.yeung@lshtm.ac.uk.
authors.forename: Shunmay
authors.initials: S
authors.lastname: Yeung
mesh_terms: D002160:Cambodia; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D008962:Models, Theoretical; D014171:Transients and Migrants