The Kenya Union of Post Primary Education Teachers (Kuppet) has given the Social Health Authority (SHA) 30 days to fix persistent failures in the teachers' medical scheme or face union action.
The union accused SHA of failing to implement commitments made in two joint communiqués signed on March 10 and April 23, 2026, to address shortcomings in the medical scheme.
Kuppet Secretary-General Akello Misori said the union had already written to SHA and expected an urgent response.
"Those 30 days are enough for us to study the operating environment and also to look at options which we can take," said Mr Misori.
The ultimatum comes three months after SHA and Kuppet agreed on measures to improve healthcare access for teachers, following concerns over delays in treatment and gaps in service delivery.
However, the union says teachers continue to experience the same problems the agreements were intended to resolve.
According to KUPPET, teachers are still being denied or forced to wait for essential diagnostic tests because of lengthy pre-authorisation procedures, recurring system outages and rationing of services at health facilities.
"Additionally, many teachers are being compelled to pay out of pocket for diagnostic tests and treatment that should be covered under the SHA benefit package," noted Mr Misori.
The Union also faulted the SHA digital platform, saying it has become a source of frustration instead of improving access to healthcare by streamlining admissions and claims processing.
KUPPET blamed the situation on SHA's failure to implement key commitments contained in the joint communiqués, which were reached after consultations initiated by Health Cabinet Secretary Aden Duale.
Among the unresolved issues is the failure to publish the official benefits structure for the teachers' medical scheme, leaving many members subjected to daily treatment caps of Sh1,200 or Sh2,000, which the union says are irregular.
The union also cited frequent system downtimes, saying Mondays have effectively become a "non-service day" in many health facilities across the country because of recurring technical failures.
KUPPET further accused SHA of failing to automate data exchange between its systems and accredited hospitals, resulting in some teachers being turned away because facilities are unable to verify their eligibility for treatment.
The union also expressed concern over the slow establishment of county joint committees meant to address complaints, saying only a handful of counties have operational committees.
It also criticised customer service, alleging that some SHA branch managers have declined to handle complaints raised by union officials.
The teachers' union also questioned the limited accreditation of fertility treatment facilities, saying only Nairobi West Hospital and Fertility Point offer in-vitro fertilisation (IVF) services under the scheme. It claimed the two facilities require teachers to pay up to Sh250,000 in cash for diagnostic procedures before treatment.
KUPPET further said there has been little progress in establishing an ex gratia management framework and group life cover for teachers, raising doubts over whether members will access the benefits they are entitled to.
The union also wants SHA to establish a dedicated toll-free line for teachers, arguing that the current customer care system relies on a single line serving all SHA beneficiaries nationwide, making it difficult for teachers to receive timely assistance.
