Relief for teachers as SHA, ministry agree on medical scheme

Health Cabinet Secretary Aden Duale, EGH (centre), Social Health Authority Chief Executive Officer Dr Mercy Mwangangi, CBS, and Union of Kenya Civil Servants Secretary General Lawrence Nyaguti Ochieng during a press briefing on teachers’ medical scheme reforms on April 23, 2026 / SCREENGRAB

Teachers will no longer be required to make any out-of-pocket payments when seeking treatment in public and contracted private hospitals, following a new agreement between the Ministry of Health, the Social Health Authority (SHA) and teachers’ representatives under the Public Officers Medical Scheme Fund (POMSF).

Health Cabinet Secretary Aden Duale said the government has directed that level 5 and 6 hospitals, as well as other contracted facilities, must provide services to teachers without charging any additional fees at the point of care.

“Teachers will not pay anything in hospital. Level 5 and 6 hospitals will fully take care of them under the scheme. That is the direction going forward,” Duale said.

The agreement comes amid sustained complaints from teachers over disruptions in service delivery under SHA, including delayed approvals, system challenges and instances where some were reportedly asked to make additional payments despite being covered.

SHA officials acknowledged operational challenges during the transition, noting that tariff controls that had caused confusion in hospitals would be withdrawn immediately to restore smooth service delivery.

During the interim period, all contracted facilities have been directed not to charge teachers any co-payments while broader nationwide tariff negotiations with health providers continue.

Under the new framework, SHA and teachers’ unions will hold monthly consultative meetings to address emerging issues and ensure uninterrupted access to healthcare services.

The meetings will bring together SHA, the Teachers Service Commission (TSC) and union leadership to monitor claims processing, hospital compliance and service delivery standards across the country.

The government has also assured teachers that reforms underway will prioritise efficiency in claims settlement and guarantee continuity of care in accredited hospitals.

Teachers’ representatives welcomed the agreement, saying it offers immediate relief but urged strict enforcement to prevent a repeat of past challenges in the rollout of the medical scheme.

A key voice in the talks said the agreement had restored confidence among teachers after weeks of uncertainty in accessing healthcare services.

“And we have for the last over one week, and now we are sure that this gesture and this agreement has restored our faith in SHA and in the leadership of the Ministry of Health and in the leadership of Waziri,” said the representative.

“We will continue to work together. And I can assure teachers that we have actually got what we wanted from Waziri, and we are so grateful. Thank you so much.”

SHA said it will also publish an updated list of contracted hospitals to help teachers easily identify facilities where they can access treatment without delays or additional charges.

The reforms are part of a broader restructuring of public officers’ healthcare under SHA, aimed at eliminating billing disputes, improving hospital reimbursements and strengthening service delivery.

While challenges remain, stakeholders say the agreement marks a significant step toward stabilising the system and restoring trust among beneficiaries.

Teachers have been assured that they will continue to access treatment without interruption and without paying any additional fees in contracted hospitals as implementation of the new framework takes effect.