Somalia: migrant health guide
Advice and guidance on the health needs of migrant patients from Somalia for healthcare practitioners.
Main messages
If the patient is new to the UK:
- explain to them how the NHS works
- discuss how this compares to the healthcare system they’ve been used to
Ensure that all patients are up-to-date with the UK immunisation schedule.
Screen all new entrants, including children, for tuberculosis (TB).
Consider screening for hepatitis B, particularly among those who have recently arrived. Somalia has a high prevalence.
Be alert for signs and symptoms of polio, and ensure vaccination as required, because polio (cVDPV3) has recently been reported in Somalia.
Ask about any travel plans the patient may have to visit friends and relatives in their country of origin, and see National Travel Health Network and Centre (NaTHNaC), or the Health Protection Scotland websites (TRAVAX and fitfortravel, for travel advice.
There is a high risk of malaria in Somalia.
There is a risk of typhoid infection in Somalia.
Female genital mutilation (FGM) has been estimated to affect more than 80% of women and girls in Somalia.
Consider nutritional and metabolic concerns.
Find out more about children’s health.
Infectious diseases
Immunisation
Ensure that all patients, especially children, are up-to-date with the UK immunisation schedule. See Immunisation collection with complete schedules
Tuberculosis (TB)
There is a high incidence of TB in Somalia (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:
- screen for STIs and HIV according to risk as specified in the UK national standards and guidelines
- test all sexually active patients under the age of 25 for chlamydia
Somalia has a low rate of HIV (≤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
- be advised that national guidelines do not recommend routine consideration of HIV testing of infants and children who have recently arrived in the UK
Hepatitis B
Somalia has a high 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 universal infant immunisation programme for hepatitis B and a selective immunisation programme for higher risk groups
Hepatitis C
Somalia has a higher prevalence of hepatitis C than the UK, so consider screening for hepatitis C if other risk factors apply.
Polio
Polio (cVDPV) has been reported in Somalia, so:
- be alert for signs and symptoms of polio in anyone arriving from Somalia, and investigate as appropriate
- ensure all new entrants are brought up to date with the UK immunisation schedule, including polio vaccine as required
- see NaTHNaC for advice about polio vaccine requirements if patients are planning to travel back to Somalia, as specific advice is in place for long-term visitors (over 4 weeks) to Somalia
Travel plans and advice
Ask about any travel plans the patient may have to visit friends and relatives in their country of origin, and see National Travel Health Network and Centre (NaTHNaC), or the Health Protection Scotland websites (TRAVAX and fitfortravel, for travel advice.
Malaria
There is a high risk of malaria in Somalia, mainly due to P. falciparum, so:
- test any unwell patient who has travelled to-and-from affected areas of Somalia in the last year
- remember that malaria can be rapidly fatal
Typhoid
There is a risk of typhoid infection in Somalia, so:
- ensure that travellers to Somalia 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 Somalia
Helminths
There is a risk of helminth infections in Somalia, including:
- schistosomiasis
- soil transmitted helminthiasis
Women’s health
Reproductive health indicators
| Reproductive health indicator | UK | Somalia |
|---|---|---|
| Children per woman¹ | 2 | 6 |
¹lifetime average
No data are available on:
- contraceptive use
- mammography screening rates
- cervical cancer screening rates
Female genital mutilation
Female genital mutilation (FGM) has been estimated to affect more than 80% of women and girls in Somalia, so be advised that:
- children born in the UK may be at risk of FGM during visits to friends and relatives in Somalia
- it is illegal to take girls who are British nationals or permanent residents of the UK abroad for FGM, whether or not it is lawful in Somalia
If you are concerned that a British citizen may be taken overseas for the purpose of FGM, please call the Foreign and Commonwealth Office on 020 7008 1500 or email fgm@fco.gov.uk.
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 >40%) and pre-school children (estimated prevalence is >40%), 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:
- covering their body for cultural or religious reasons (lack of sunlight)
- skin colour
- diet (vegan or vegetarian)
Vitamin A
There is a high risk of vitamin A deficiency in Somalia.
Country profile
Health indicators and health care
WHO Global Health Observatory has a summary of health indicators and health care in Somalia.
Culture, politics and history
BBC News and The World Factbook provide background information on the culture, politics and history of Somalia.
Languages
The main languages used in Somalia are:
- Somali (official)
- Arabic (official, according to the Transitional Federal Charter)
- Italian
- English
Source: The World Factbook.
Find out about language interpretation.
Religions
Sunni Islam is the official religion of Somalia, according to the Transitional Federal Charter.
Source: The World Factbook.
Migration to the UK
There were over 101,000 people from Somalia living in England and Wales at the time of the 2011 Census.
Source: Office for National Statistics © Crown Copyright 2014.
Last updated 24 May 2019 + show all updates
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Updated polio guidance.
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Updated advice on testing for hep B and anaemia based on current prevalence in Somalia.
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First published.