Why teachers are pushing to leave the SHA scheme

Kuppet officials addressing the media outside Nairobi's Aga Khan Hospital on Thursday, March 5, 2026. /SCREENGRAB

The education sector could face its first teachers’ strike of the year if the Kenya Union of Post-Primary Education Teachers makes good its threat to boycott work over concerns about the new medical scheme for public officers.

The union claims the Public Officers Medical Scheme Fund (POMSF), managed by the Social Health Authority (SHA), does not provide comprehensive medical cover for teachers.

Kuppet leaders now want teachers removed from the scheme and have issued a strike notice, warning that members could take to the streets if their grievances are not addressed.

“We are therefore giving SHA a seven-day notice to style up otherwise we shall be calling our members to be on the streets because this thing cannot work,” Kuppet secretary general Akelo Misori said.

Misori spoke on Thursday outside Aga Khan Hospital, where union officials had gathered to contribute funds to offset a medical bill of more than Sh1 million for a teacher injured in the January 31 accident in Ngara.

Three teachers died in the incident after a CBD-bound matatu that had reportedly lost its brakes ploughed into a group gathered outside City Primary School, where branch elections had just been concluded.

The Teachers Service Commission (TSC) stated at the time that SHA would fully cover all medical bills arising from hospitalisation.

Despite the assurance, Kuppet claims teachers have returned to holding harambees to facilitate the discharge of colleagues who remain hospitalised for long periods.

“This is something that we have never seen in the last 16 years,” Kuppet national chairman Omboko Milemba said.

“SHA is not working for teachers. We are back to raising funds for a teacher to be discharged from hospital and we are not going to accept that,” he added.

What Kuppet says is wrong with SHA

According to Kuppet, SHA has fallen short on a number of benefits teachers previously enjoyed under earlier medical covers.

Union officials argue that the fund is insufficient because its coverage is limited.

“We have teachers who could not be treated because the cover is said to have lapsed. When a teacher has stayed in the hospital for only three days, SHA says they cannot proceed to pay,” Misori said.

The union has also faulted SHA for what they termed as failing to provide benefits teachers were previously entitled to, including the last expense benefit.

Under the previous teachers’ medical cover managed by Minet Kenya, the last expense component provided immediate financial assistance to the next of kin to cater for funeral and burial arrangements upon the death of an insured member.

The benefit was generally capped at Sh300,000 for the principal member (teacher) and, in some variations, eligible dependents.

It was intended to cover funeral costs and ease financial pressure on families during bereavement.

“Upon a teacher’s death, we used to receive last expense and the money would be processed within 48 hours. SHA does not have that but they had promised they would offer it,” Milemba said.

He added that the authority had also promised to provide group life cover, an employer-provided insurance policy that pays a tax-free lump-sum benefit to beneficiaries if an employee dies or becomes permanently disabled while still in service.

“Formerly, we had full ex gratia; now, ex gratia is being paid at 50 per cent, and you must go looking for it with a torch. Up to this point, we are still demanding for it at the Teachers Service Commission,” Milemba said.

Kuppet has also raised concerns about the limited number of health facilities accredited to offer services to teachers under SHA.

Misori said some hospitals in Nairobi have been turning teachers away on the grounds that they are not accredited to provide services to that category of civil servants.

Of the 26 teachers injured in the Ngara accident, three were admitted at Aga Khan Hospital, eight at Nairobi West Hospital, one at Kenyatta National Hospital and one at AAR Kiambu Road. Thirteen others were treated and discharged.

Kuppet says if SHA does not expand the scope of its cover, the union would prefer a return to the medical scheme previously administered by Minet Kenya.

However, despite the union’s sharp criticism, Health Cabinet Secretary Aden Duale said SHA was fully operational and performing exceptionally well.

He said the health needs of teachers were being met without disruption, dismissing claims that educators were being turned away or denied care.

“As of our latest performance review, over 249,000 teachers and their dependants have successfully been seen and treated across the country, with current claims standing at over Sh3.5 billion," he said in a statement.

"Unlike the restrictive, tiered networks of the past, teachers now enjoy unparalleled choice and accessibility,” he added.

Duale said that since the rollout of SHA, teachers have received care in 2,823 different health facilities across the country.