Guidance

Ukraine: migrant health guide

Advice and guidance on the health needs of migrant patients from Ukraine 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) from this country for tuberculosis (TB).

There is a high burden of Multi Drug Resistant Tuberculosis (MDR-TB) in Ukraine.

Ascertain any risk factors for hepatitis B infection that may indicate the need for screening, because Ukraine has a low prevalence.

Consider screening for hepatitis C, because Ukraine has a considerably higher prevalence than the UK.

Ask opportunistically 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.

Be advised that there is a risk of typhoid infection in Ukraine.

Tuberculosis

The incidence of TB in Ukraine is very high (>500 cases/100,000), and there is also a high burden of MDR-TB, so:

  • screen all new entrants, including children, for TB according to NICE guidelines
  • refer to TB services promptly if screening is positive
  • seek advice, if you are a local TB service, from the MDR-TB Clinical Advice Service before treating patients from Ukraine for TB
  • 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

Ukraine has a low rate of HIV, 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

Ukraine has a low prevalence of hepatitis B, so:

  • 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 selective immunisation programme for hepatitis B

Hepatitis C

Ukraine has a considerably higher prevalence of hepatitis C than the UK, so consider screening for hepatitis C.

Travel plans and advice

Ask opportunistically 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.

Typhoid

There is a risk of typhoid infection in Ukraine, so:

  • ensure that travellers to Ukraine 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 Ukraine

Women’s health

Reproductive health indicators

Reproductive health indicator UK Ukraine
Number of children per woman¹ 2 1
Breast examination or mammography² 75% 34%
Cervical cancer screening³ 70% 75%

¹lifetime average; ²women aged 50 to 69 years; ³women aged 20 to 69 years

No data is available on contraceptive use.

Nutritional and metabolic concerns

Anaemia

There is a moderate risk of anaemia in adults (estimated prevalence in non-pregnant women is 20 to 40%) and pre-school children (estimated prevalence is 20 to 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 Ukraine.

Iodine

People from Ukraine may be at risk of mild iodine deficiency due to inadequate intake.

Country profile

Health indicators and health care

WHO Global Health Observatory has a summary of health indicators and health care in Ukraine.

Culture, politics and history

BBC News and The World Factbook provides background information on the culture, politics and history of Ukraine.

Languages

Language Population (%)
Ukrainian¹ 67
Russian² 24
Other³ 9

¹official; ²regional language; ³includes small Romanian, Polish and Hungarian-speaking minorities

Source: The World Factbook.

Religions

The main religions in Ukraine are:

  • Orthodox: includes Ukrainian Autocephalous Orthodox (UAOC), Ukrainian Orthodox - Kyiv Patriarchate (UOC-KP), Ukrainian Orthodox - Moscow Patriarchate (UOC-MP)
  • Ukrainian Greek Catholic
  • Roman Catholic
  • Protestant
  • Muslim
  • Jewish

Source: The World Factbook.

Migration to the UK

At the time of the 2011 census there were almost 21,000 people from Ukraine living in England and Wales.

Source: Office for National Statistics

Published 31 July 2014
Last updated 27 July 2018 + show all updates
  1. Updated HIV guidance with latest (2016) UNAIDS data.
  2. First published.