Teachers' beef with SHA as Duale meets Kuppet

It followed a seven-day ultimatum issued by Kuppet last week to address grievances teachers have raised about Social Health Insurance Fund, the medical insurance cover offered by SHA.

More than 400,000 teachers are under the cover.

Also Read: Teachers threaten strike as SHA woes continue, three months after onboarding

“We needed clarity on the benefits due to teachers and also the clumsy platform where hospitals say the system is slow and turn away teachers. There are also issues with the levels of authorisation before teachers are treated,” Kuppet secretary-general Akello Misori told Nation.

According to sources who attended the meeting, the CS did not address glaring funding gaps and concerns over crucial provisions under the SHA.

Overdue last expense payments were also not adequately addressed, some of which remain unpaid since December 2025. Insurers say they cannot cover these costs, leaving the burden to TSC. However, the commission revealed that it lacks the necessary resources and requested additional funding.

Kuppet officials also pressed for a medical cover for the over 20,000 intern teachers serving in schools. The TSC said it would require Sh1 billion to have the teachers under the scheme.

On overseas medical treatment, teachers can access treatment at nine accredited hospitals — three in Turkey, four in India, and two in Saudi Arabia. 11 hospitals have also been approved for IVF treatment.

Also Read: Kuppet demands SHA overhaul as teachers ‘detained’ over bills

Teachers have been complaining that some hospitals decline or delay treating them, insisting on cash payment. According to KUPPET, the anomaly became more evident last month when some of its members were involved in an accident were allegedly turned away from several hospitals despite being in critical condition.

When they emerged from the meeting at Afya House to address the press, Mr Duale warned that health facilities accredited under the SHA that turn away patients risk deregistration and revocation of their operating licenses.

“If we find that you have denied Kenyans this basic constitutional right to the attainment of healthcare, not only shall we suspend you from the SHA portal, we will go further and deny you the license to operate,” cautioned Mr Duale.

He noted that it was inhumane that some health facilities would pioritise money over human life, by giving excuses that SHA has not paid them.

“Be reminded that you have signed a contractual agreement by law with SHA. SHA will pay you in accordance with the law and the law says payments will be done within 90 days,” he said.

On Monday night, the SHA released Sh4.1 billion to primary healthcare facilities across the country, covering payments for October, November, December and January, to benefit public, private and faith-based health facilities. Another Sh11.3 will be released up until March 14 2026.

Also Read: Teachers start receiving healthcare services under SHA  

The TSC in December last year migrated teachers from Minet Kenya to the SHA promising to offer a comprehensive medical cover.

Last week, the KUPPET had issued the SHA management a seven-day ultimatum to address the detention of teachers in hospitals over unpaid medical bills and to clarify the accreditation status of medical facilities.

The union had warned that it would be calling out its members to the streets if the government failed to heed to its call and address the challenges that had emerged under SHA medical cover for teachers.

“With this kind of assurance we are now sure that our teachers will have a seamless engagement with the health facilities,” said Mr Misori.

KUPPET leaders maintained that the union will only be satisfied when teachers can access treatment without being turned away from hospitals.

“We are not yet satisfied. What matters is what happens on the ground. Teachers should be able to walk into hospitals and receive treatment without difficulties,” an official told the Nation.

Following tripartite deliberations on the Mwalimu Cover, it was agreed that quarterly mandatory consultative forums will be held to review utilisation patterns and the overall functionality of the scheme, in a bid to enhance accountability.

Additionally, the Social Health Authority (SHA) has set up a dedicated toll-free line — 0800 720 601 — and shortcode 147 as a rapid response channel exclusively for teachers facing emergencies or administrative challenges at health facilities.

“We have also agreed on automation of data exchange and beneficiary registration to permanently resolve transitional anomalies such as missing biodata and unmapped dependents,” said Mr Duale.

This will enable real time updates to the Mwalimu Cover Beneficiary Register, ensuring no teacher is denied care due to data synchronization delays.

There will also be publication and clarification of the benefits structure for the Teachers Medical Scheme, and this is aimed at distinguishing the enhanced benefits teachers are entitled to under the Mwalimu Cover.

Alongside this, SHA, TSC and KUPPET will immediately co-facilitate continuous nationwide education campaign to enlighten teachers on their benefit entitlements.

“I encourage teachers to familiarise themselves with their benefits and use them in line with the scheme’s structure so they can fully benefit from the cover throughout its duration,” said TSC chief executive Evaleen Mitei.

It has since been categorically clarified that the Group Life Cover and Work Injury Benefits Act (WIBA) provisions are not administered under the SHA although they were there under the Minet Kenya cover. This will be a function of the Exchequer.

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