Fiji: migrant health guide

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 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:

• 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 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 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.

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.

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

Helminths

There is a risk of soil transmitted helminth infections.

Women’s health

Reproductive health indicators

Reproductive health indicator	UK	Fiji
Number of children per woman [lifetime average]	1.6	2.5
Use of contraception [by woman of reproductive age or partner]	71.7%	36.1%

Nutritional and metabolic concerns

Anaemia

There is a high risk of anaemia in adults (estimated prevalence in non-pregnant women is >40%) and a moderate risk in 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 risk of vitamin A deficiency.

Iodine

There may be a risk of of moderate 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 Fiji.

Culture, politics and history

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

Languages

Languages used in Fiji include:

• English (official)
• iTaukei (official)
• Fiji Hindi (official)

Source: The World Factbook.

Religions

Religion	Population (%) (2007 estimates)
Protestant (Methodist 34.6%, Assembly of God 5.7%, Seventh Day Adventist 3.9%, and Anglican 0.8%)	45
Hindu	27.9
Other Christian	10.4
Roman Catholic	9.1
Muslim	6.3
None	0.8
Sikh	0.3
Other	0.3

Source: The World Factbook.

Migration to the UK

There were over 7,700 people from Fiji living in England and Wales at the time of the 2021 Census.

Source: Office for National Statistics.