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:

Screen all new entrants, including children, for tuberculosis (TB).

Due to a low prevalence, ascertain any risk factors for hepatitis B infection that may indicate the need for screening.

Consider screening for hepatitis C because of a considerably higher prevalence than the UK.

There is a risk of typhoid infection.

Consider nutritional and metabolic concerns.

Work with a professional interpreter where language barriers are present.

Consider the impacts of culture, religion and gender on health.

Assess for mental health conditions.

Refer pregnant women to antenatal care.

No charges for the use of most NHS services for new arrivals from Ukraine

The Department of Health and Social Care (DHSC) amended the NHS Charges to Overseas Visitors Regulations 2015 on 17 March 2022, to ensure that anyone who is ordinarily resident in Ukraine, but lawfully in the UK, from 24th February is exempt from charge for NHS treatment (except assisted conception services) in England.

This exemption reflects that of the Family and Sponsorship routes to ensure that those fleeing Ukraine, who are in the UK lawfully, are not charged to use the NHS in England (aside from assisted conception). This exemption will be reviewed before mid-September.

For further information on the visa routes available for Ukrainian nationals, please see: UK visa support for Ukrainian nationals - GOV.UK (www.gov.uk).

A Written Ministerial Statement made on 17th March 2022 provides additional information on the amendment, please see: Written statements - Written questions, answers and statements - UK Parliament.

Infectious diseases

Immunisation

Ensure that all patients, especially children, are up-to-date with the UK immunisation schedule. See the immunisation collection with current schedules.

Tuberculosis

There is a high incidence of TB approximately 73 per 100,000 population, 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

There is 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

Hepatitis B

There is 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 universal infant immunisation programme for hepatitis B and a selective immunisation programme for higher risk groups

Hepatitis C

The prevalence of hepatitis C is considerably higher than the UK, so consider screening for hepatitis C.

Typhoid

There is a 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

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, Commonwealth and Development Office for overseas travel advice and National Travel Health Network and Centre (NaTHNaC) for country specific travel advice prior to leaving the UK.

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:

  • darker skin
  • those who are not often outdoors
  • those who cover up most of their skin when outdoors

Vitamin A

There is a high risk of vitamin A deficiency.

Iodine

There may be a risk of risk of mild iodine deficiency due to inadequate iodine intake.

Women’s health

Reproductive health indicators

Reproductive health indicator UK Ukraine
Number of children per woman [note 1] 1.7 1.2
Use of contraception [note 2] 71.7% 65.4%

Note 1: lifetime average
Note 2: by woman of reproductive age or partner

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 (%)
Ukrainian (official) 67.5
Russian [note 1] 29.6
Other [note 2] 2.9

Note 1: regional language
Note 2: includes small Crimean Tatar, Moldovan/Romanian, and Hungarian speaking minorities

Source: The World Factbook.

Religions

The main religions in Ukraine are:

  • Orthodox, which includes the Orthodox Church of Ukraine (OCU), Ukrainian Autocephalous Orthodox Church (UAOC), and the Ukrainian Orthodox-Moscow Patriarchate (UOC-MP)
  • Ukrainian Greek Catholic
  • Roman Catholic
  • Protestant
  • Muslim
  • Jewish

Source: The World Factbook.

Migration to the UK

In response to the Russian invasion of Ukraine, 2 UK government visa schemes have been launched:

  • the Ukraine Family Scheme allows applicants to join family members or extend their stay in the UK
  • the Ukraine Sponsorship Scheme allows Ukrainian nationals and their family members to come to the UK if they have a named sponsor under the Homes for Ukraine Scheme

The latest data on applications to come to or stay in the UK under these schemes is available from the Home Office and UK Visas and Immigration.

At the time of the 2021 census there were over 37,500 people from Ukraine living in England and Wales.

Source: Office for National Statistics

Arrivals from Ukraine: advice for primary care

The UK Health Security Agency has produced guidance for primary care professionals concerning arrivals from Ukraine.

Published 31 July 2014
Last updated 14 July 2022 + show all updates
  1. Updated to include the charging exemption message for the use of most NHS services for new arrivals from Ukraine

  2. Migration to the UK section has been updated to include information on the resettlement schemes and latest migration statistics based on Census 2021 data. TB incidence data has also been updated.

  3. Added a link to UKHSA advice for primary care.

  4. Updated country guidance on prevalence of communicable diseases and other health topics.

  5. Updated HIV guidance with latest (2016) UNAIDS data.

  6. First published.