Teachers have criticised Cabinet Secretary Aden Duale, saying they will take action if the Ministry of Health does not meet with them to address challenges in the new medical scheme.
In a press statement, Mr Duale hailed the scheme as “fully operational,” saying more than 249,000 teachers and dependants have accessed treatment at 2,823 hospitals out of a promised 9,000, with Sh3.5 billion in claims processed.
“We wish to assure our teachers and the general public that there is no cause for alarm. Administered under the Social Health Authority (SHA), it is not only fully operational but is performing exceptionally well, ensuring that the health needs of our educators are met without disruption,” Mr Duale said in his statement on Thursday evening.
“To set the record straight and dispel any narrative suggesting that teachers are being turned away or denied care, the data speaks for itself. We urge teachers to continue utilising the SHA contracted health facilities available to them ... with full confidence. The government remains steadfast in its commitment to protecting the health and dignity of the Kenyan teacher.”
According to the ministry, the scheme has shown significant uptake in several counties.
Nairobi leads with 30,766 claims amounting to Sh527.7 million, followed by Uasin Gishu, which has recorded 29,212 claims of Sh463.2 million.
Health Cabinet Secretary Aden Duale during an interview in Nairobi on January 26, 2026.
Photo credit: Dennis Onsongo | Nation Media Group
Meru has reported the highest number of claims at 34,189, valued at Sh243.8 million, while Bungoma has registered 29,743 claims of Sh237.6 million.
Other areas where teachers are heavily utilising the medical cover, according to the ministry, are Kisii, Kisumu, Nakuru, Kiambu, Trans Nzoia and Kericho.
However, the Kenya Union of Post-Primary Education Teachers (Kuppet) and the Kenya National Union of Teachers (Knut) say the glowing picture painted by the government is far from real, accusing the ministry of downplaying challenges tutors face when seeking healthcare.
The unions say the scheme has left many teachers struggling with delayed pre-authorisation, difficulties during hospital discharge and limited access to treatment.
“We have a managed scheme by SHA, and if it is not sufficient, then it is not sufficient,” Kuppet Secretary-General Akelo Misori said on Friday.
“The CS should come out clearly and explain why teachers are complaining. We have cases of teachers raising concerns about pre-authorisation and challenges during discharge from hospital.”
He added that Kuppet has requested a meeting with the government to address the concerns, warning that the union could take further action if the issues are not resolved urgently.
“If the meeting does not take place, the government will only see action. We don’t have time to engage in politics. If the minister is doing that, it is very unfortunate,” Mr Misori said.
Knut also questioned the deal, saying glitches in the system have prevented teachers from receiving healthcare.
“We face serious challenges. It always comes down to money. We are now being told that the National Treasury has not released funds,” Knut Secretary-General Collins Oyuu said on Friday.
“It is always money, money and money. In the meantime, teachers are suffering. We will meet to assess the situation. We will come up with a review by the end of this month. Teachers should not continue suffering.”
The Social Health Authority building in Nairobi.
Photo credit: File | Nation Media Group
Mr Oyuu’s deputy, Hesbon Otieno, said system failures are not curing teachers’ illnesses.
“Teachers should get treatment even as the system is being corrected or repaired. They cannot wait. Kuppet county executive secretaries are calling us, saying teachers are not being attended to at hospital because of the delays. The secretary-general spoke to the SHA director, who confirmed that there have been delays.”
Knut said teachers in several counties have raised concerns over delays in approvals for specialised treatment, referrals and benefit limits.
Some private hospitals have reportedly declined to admit SHA patients, citing administrative bottlenecks and delayed reimbursement.
Mr Misori also questioned the earlier promise by the government on teachers having access to 9,000 hospitals under the scheme.
“We have not been given clear data on how many hospitals are accredited. Some who were serving teachers under the former scheme are no longer on the list. It has made teachers travel long distances in search of treatment,” the Kuppet boss said.
“Teachers are raising funds to help colleagues settle medical bills. This shows the scheme is not working as it should.”
According to Kuppet, only two hospitals in Bungoma and three in Kisumu are attending to teachers under SHA.
“We are, therefore, giving SHA management a seven-day notice to engage us. If not, we shall call on our members to be on the streets,” Mr Misori said.
Kuppet says at least 14 teachers are stranded in the hospital due to challenges in accessing services under the new medical cover. It is looking into the cases.
“The biggest issue teachers are talking about is medical treatment. If teachers were being treated in hospital, they would not be complaining,” Kuppet Deputy Secretary-General Moses Nthurima said.
“Many of them are being turned away from hospital. That is why we must speak out. Teachers are being denied treatment because the system is not working. They cannot remain silent.”
Mr Nthurima accused authorities of peddling falsehoods by insisting that the system is functioning while many teachers continue to face problems.
He said tutors are aware of the realities on the ground and cannot be convinced by assurances that do not match their experiences.
“Teachers are not ignorant. You cannot keep telling them that the system is working when they are being turned away from hospital. You cannot claim you are on duty when you are missing in action,” he said.
“If the government wants the support of teachers, it must ensure the health scheme works. If it continues with the same rhetoric while teachers are suffering, we will reject it.”
“The ministry and SHA have not called us for a meeting. They are not picking our calls. We have even visited their offices and found no one there. The truth is that we are dealing with technology and a system that is not working,” he said.
In the current budget estimates, the Teachers Service Commission (TSC) proposed Sh16.5 billion for teachers’ medical cover under SHA.
The commission has, however, indicated that the allocation may not be adequate, given the recruitment of more teachers and the size of the beneficiary pool.
“Corruption should not get space in this scheme, like it was with the National Health Insurance Fund. Many viable government schemes collapse under the weight of corruption and incompetence,” Education Stakeholders Association of Kenya Secretary Ndung’u Wangenye said on Friday.
“It will be irresponsible to move from a private medical provider to a government provider (SHA), and within one year, we will be back at a private provider. That’s shameful.”
According to the TSC presentation on the cover under the Public Officers Medical Scheme Fund, several health services have set benefit limits under the framework managed by SHA.
The Social Health Insurance Fund provides inpatient cover of Sh2,240 to Sh4,480 a day for up to 180 days per household, while maternity services are capped at Sh10,000 for normal delivery and Sh30,000 for Caesarean section.
“SHA has received isolated reports of teachers experiencing challenges when accessing care. These cases are not widespread or systemic and do not reflect the intended operation of the scheme,” SHA Chief Executive Mercy Mwangangi said.
