The concept of key populations in the malaria response is relatively new and so not yet fully defined, but those that fall within the definition include:
Poverty, marginalization and lack of access to basic resources heighten vulnerability to malaria. Populations most affected by malaria are also those that are often disproportionately affected by poverty, social inequality and political marginalization.
In most of Africa, where malaria is a leading cause of death, the marginalized status of populations such as pregnant women and children, migrants, refugees, prisoners, rural populations and indigenous populations, means that these populations often lack basic resources – such as safe and secure housing, water and sanitation – to promote their health and well-being.
Additionally, malaria prevention and treatment services are available, but socioeconomically and politically marginalized populations struggle to access services. They do not get the necessary health information and services, cannot afford preventive insecticide-treated bed nets and malaria treatment and cannot always protect their rights to voluntary and informed prevention, diagnosis, treatment and care.
Source: WHO Fact Sheets: Malaria, 2021
Evidence shows that protecting and promoting the rights of affected populations reduces malaria-related morbidity and mortality.
Control and Prevention of Malaria (CAP-Malaria), a USAID-supported project that implemented malaria prevention and treatment interventions in the border regions of Thailand, Cambodia and Burma, has been used to engage with the mobile and migrant populations at high risk of malaria.
The vast number of mobile and migrant populations living in the border regions move through high-risk transmission areas and are difficult to diagnose, treat and track due to routine traveling. They also often avoid interaction with public services because of undocumented status or the informal or illegal nature of their work. Barriers such as language, legal status issues, and lower socioeconomic status prevent mobile and migrant populations from receiving insecticide-treated bed nets (ITNs) and prompt treatment for fever.
The CAP-Malaria project identified hot spots and touch points to communicate with prioritized groups. For example, to reach populations connected to the agriculture sector, CAP-Malaria introduced lending schemes to encourage farms and plantations to expand net coverage to highly mobile employees, not generally reached by universal campaigns, for the duration of their stay. CAP-Malaria also expanded access to testing and treatment by coordinating activities between sedentary populations and mobile and migrant sub-groups they interact with. For example, CAP-Malaria worked with employers to identify and train non-registered private health providers, who were often the first people mobile and migrant populations or villagers would go to for treatment.
Read more: The Health Communication Capacity Collaborative (HC3)
The Roll Back Malaria Partnership is a global framework for coordinated action against malaria. It initially started as a partnership with WHO, UNICEF, UNDP and the World Bank, and now consists of hundreds of partners.
The partnership provides global strategy through Action and Investment to Defeat Malaria 2016-2030 (AIM) which outlines strategic approaches to building investment in malaria, promoting an inclusive approach, creating supportive elements such as strengthening the enabling environment, and ensuring progress and accountability.
WHO’s Global Technical Strategy for Malaria 2016-2030 complements the global strategy and outlines a strategic framework with a focus on universal access to malaria prevention, diagnosis and treatment, transforming and improving surveillance efforts, harnessing innovation, strengthening the enabling environment through stronger health systems and promoting inventions that act as an entry point to maternal and child health programmes, among other initiatives.
The Multisectoral Action Framework for Malaria, also developed through the Roll Back Malaria Partnership, provides programmatic guidance. The Action Framework analyses the social and environmental determinants of malaria at societal, environmental, population group, and household level and advocates for financing for: