Civil servants, teachers hit out at SHA over cuts
The Union of Kenya Civil Servants (UKCS) claims the Social Health Authority (SHA) illegally altered medical contracts without consulting the union or the Ministry of Public Service.
The Union of Kenya Civil Servants (UKCS) has condemned the Social Health Authority (SHA), accusing the health body of unilaterally and illegally altering medical insurance contracts for thousands of government workers.
Speaking at a press briefing following the union's recent leadership transition, newly elected Secretary General Lawrence Nyaguti warned of a deepening crisis in the public service sector, pointing to health insurance cuts that he said had left civil servants effectively uninsured.
Nyaguti said SHA had introduced a restrictive cap of Sh2,500 per outpatient visit, locking members out of meaningful healthcare access.
"In our contract, we agreed that members are going to enjoy the insurance terms both outpatient and inpatient. Within the last week, SHA has limited the outpatient scheme to 2,500, which basically means that we as civil servants are not insured because 2,500 is merely a consultation fee, especially in private facilities. But most of the reasons why people want health cover are mostly outpatient, not even inpatient," he said.
He also accused SHA of breaching contractual obligations by failing to consult the union or the Ministry of State for Public Service before making the changes.
"The other thing they breached in the contract is that whenever there is any change, they have to consult. They have not consulted the union and the ministry responsible for signing that contract, which is the Ministry of State for Public Service," Nyaguti added.
The Social Health Authority building in Nairobi.
The union further expressed frustration that hospitals registered under SHA appeared unable to distinguish between the Universal Health Coverage (UHC) framework and the Public Officers Medical Scheme fund, a separate arrangement established in 2024 to provide comprehensive, supplementary health coverage to civil servants, teachers, and disciplined services personnel. The fund is designed to finance medical, dental, optical, and inpatient/outpatient care for public officers and their dependents, stepping in once SHIF benefits are exhausted.
Nyaguti said members had been turned away from hospitals or forced to pay out of pocket before receiving treatment.
"When our members got to hospitals, they refused to attend to them. The facilities want them to pay before being served, which is illegal. So, we have told members to give us the names of those facilities that are demanding money," he said.
He warned that the union was prepared to take legal action if SHA did not honour the contract.
"We are not happy. We are aggrieved, and because of that breach of contract, we'll act. We may take legal action or any other action that is necessary to ensure that SHA obeys or stops violating the contract," the union official said.
Teachers, who were brought into the fund in December 2025, have voiced similar complaints, citing administrative failures, delays in hospital admissions, and outright rejection at major private hospitals where new systems are yet to be fully integrated.
Many have reported being handed large bills for procedures previously covered under their old scheme, including treatment for premature births and chronic illnesses, pushing families into financial distress.
"SHA has lately refused to cover teachers comprehensively, leaving teachers to pay their own bills. Teachers are detained over health bills, yet they are civil servants. SHA is NOT working," said one teacher who sought anonymity.
Another added: "SHA comprehensive cover in 2025 was presented to teachers of Kenya as the best insurance to cover medical bills. From Saturday, the 12th, 2026, all teachers visiting the medical facility are allocated Sh2,500 per visit, forcing many to top up with cash from their pockets. It is unfortunate."
David Bor, Executive Secretary of the Kenya National Union of Teachers (Knut) Kipkelion branch, called for urgent government intervention.
"We need the government to review SHA. SHA is not working for teachers. The so-called ‘Mwalimu Cover’ is not producing anything. Teachers are moving from one hospital to the other and there are no services they are being given. Teachers are required to buy drugs yet they are the highest paying members of SHA. We have given the government time, and that time is almost going out. We want a lot of reforms and we demand for a meeting so that the pertinent issues are resolved," he said.
Stephen Langat, Secretary General representing Junior Secondary School teachers in Kuppet, Nandi County, raised concerns about the reduction in coverage limits.
"Sometimes, the amount surpasses the amount SHA provides. When we were under Minet, we were not adding any amount. The medical scheme was covering a maximum of five million, but at the moment we have a maximum of 1.5 million, which is a great problem. I call upon the government to streamline this issue. Failure to do so, we will go to the streets, and paralyse learning," he said.
Both Kuppet and Knut have threatened to pull out of the SHA medical cover arrangement and warned of a national strike or boycott if the cover is not restored to its previous standards.
Nation reached out to SHA Chairperson Dr Abdi Mohamed, SHA Chief Executive Officer Mercy Mwangangi, and Health Cabinet Secretary Aden Duale for comment. None had responded by the time of going to press.
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