Guidance

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.

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:

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.

Updates to this page

Published 31 July 2014
Last updated 24 May 2019 + show all updates
  1. Updated polio guidance.

  2. Updated advice on testing for hep B and anaemia based on current prevalence in Somalia.

  3. First published.

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