India: migrant health guide
Advice and guidance on the health needs of migrant patients from India for healthcare practitioners.
Main messages
If the patient is new to the UK:
- explain to them how the NHS works and their entitlements to healthcare
- discuss how this compares to the healthcare system they’ve been used to
- follow guidance on how to comprehensively assess new migrant patients
- ensure that they are up to date with the UK immunisation schedule
- ask about any travel plans the patient may have to visit friends and relatives in their country of origin
Screen all new entrants, including children, for tuberculosis (TB).
Due to an intermediate prevalence, consider screening for hepatitis B, particularly among those who have recently arrived.
There is a risk of malaria in some areas.
There is a high risk of typhoid infection.
Consider nutritional and metabolic concerns.
Infectious diseases
Immunisation
Ensure that all patients, especially children, are up to date with the UK immunisation schedule.
Tuberculosis (TB)
There is a high incidence of TB (40 to 499 cases per 100,000), so:
- screen all new entrants (including children) for TB according to NICE guidelines
- refer to TB services promptly if screening is positive
- maintain long term vigilance for symptoms of TB even if initial screening is negative
- be aware that TB is a notifiable disease
Sexually transmitted infections and HIV
Take a sexual history, and:
- test all sexually active patients under the age of 25 for chlamydia
- screen for STIs and HIV according to risk as specified in the UK national standards and guidelines
There is a low rate of HIV (less than or equal to 1%), so offer and recommend an HIV test if the patient:
- falls into a high risk group
- is newly registering in a high prevalence area
Hepatitis B
There is an intermediate prevalence of hepatitis B, so:
- consider screening for hepatitis B, particularly those who have recently arrived
- offer screening for hepatitis B to all pregnant women during each pregnancy
- immunise appropriately babies born to mothers who are hepatitis B positive and follow up accordingly
- be aware that the UK has a a universal infant immunisation programme for hepatitis B and a selective immunisation programme for higher risk groups
Hepatitis C
The prevalence of hepatitis C is higher than the UK, so consider screening for hepatitis C if other risk factors apply.
Malaria
There is a risk of malaria in some areas, due to P. falciparum and P. vivax, so:
- test any unwell patient who has travelled to and from affected areas in the last year
- remember that malaria can be rapidly fatal
Typhoid
There is a high risk of typhoid infection, so:
- ensure that travellers are offered typhoid immunisation and advice on prevention of enteric fever
- remember enteric fever in the differential diagnosis of illness in patients with a recent history of travel to or from this country
Helminths
There is a risk of soil transmitted helminth infections.
Travel plans and advice
Ask opportunistically about any travel plans the patient may have to visit friends and relatives in their country of origin. People who travel to visit friends and relatives (VFR travellers) should visit the Foreign and Commonwealth Office for overseas travel advice and National Travel Health Network and Centre (NaTHNaC) for country specific travel advice prior to leaving the UK.
Women’s health
Reproductive health indicators
| Reproductive health indicator | UK | India |
|---|---|---|
| Number of children per woman (lifetime average) | 1.6 | 2.2 |
| Use of contraception (by woman of reproductive age or partner) | 71.7% | 53.5% |
Female genital mutilation
Female genital mutilation (FGM) has occasionally been documented in India.
Find out more about women’s health.
Nutritional and metabolic concerns
Anaemia
There is a high risk of anaemia in adults (estimated prevalence in non-pregnant women is greater than 40%) and in pre-school children (estimated prevalence is greater than 40%), in India, so:
- be alert to the possibility of anaemia in recently arrived migrants, particularly women and pre-school children
- test as clinically indicated
Vitamin D
Consider the possibility of vitamin D deficiency in people who may be at risk due to:
- darker skin
- not spending much time outdoors
- covering up most of their skin when outdoors
Vitamin A
There is a high risk of vitamin A deficiency.
Country profile
Health indicators and health care
WHO Global Health Observatory) has a summary of health indicators and healthcare in India.
Culture, politics and history
BBC News and The World Factbook provide background information on the culture, politics and history of India.
Languages
| Language | Population (%) |
|---|---|
| Hindi | 41 |
| Bengali | 8.1 |
| Telugu | 7.2 |
| Marathi | 7 |
| Tamil | 5.9 |
| Other | 5.9 |
| Urdu | 5 |
| Gujarati | 4.5 |
| Kannada | 3.7 |
| Malayalam | 3.2 |
| Oriya | 3.2 |
| Punjabi | 2.8 |
| Assamese | 1.3 |
| Maithili | 1.2 |
Source: The World Factbook, India
Find out about language interpreting.
Religions
| Religion | Population (%) (2011 census estimates) |
|---|---|
| Hindu | 79.8 |
| Muslim | 14.2 |
| Christian | 2.3 |
| Sikh | 1.7 |
| Other and unspecified | 2.0 |
Source: The World Factbook, India
Migration to the UK
There were over 920,000 people from India living in England and Wales at the time of the 2021 Census.
Last updated 11 April 2023 + show all updates
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Updated: the Hepatitis B prevalence level, vitamin D deficiency risk groups, proportions of the population with different religions and migration to the UK statistics.
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Updated advice on testing for hep B and awareness of FGM, based on current prevalence in India.
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First published.