The Teachers Service Commission (TSC) is facing a Sh1.4 billion shortfall in teachers’ medical cover, warning that some hospitals could start turning away teachers by May–June due to delayed funding.
Full implementation of the Mwalimu Cover under the Public Officers Medical Scheme Fund that is administered by the Social Health Authority (SHA) requires Sh8.9 billion.
The TSC noted it had been allocated Sh7.5 billion in the Supplementary Budget for the year ending June 2026, meaning there is an underfunding of Sh1.4 billion.
“Any underfunding towards May-June could mean that some hospitals will be unable to treat our teachers, as they will not have received the necessary funding,” TSC Senior Deputy Director Finance Frankline Choge told the National Assembly Committee on Education.
He issued the warning following mounting complaints from teachers that some hospitals had declined or delayed treating them, insisting on cash payment.
The TSC in December last year migrated 415,000 teachers and their dependents teachers from Minet Kenya to the SHA meaning the Sh8.9 billion covers seven months in the financial year 2025/2026.
Documents tabled in Parliament show the Commission owes Minet Kenya Sh7.44 billion for medical cover of teachers as at November 30 2025 when the contract lapsed.
Teachers Service Commission CEO Evaleen Mitei speaks to the media at the Ministry of Health offices in Nairobi on March 10, 2026.
Photo credit: Bonface Bogita | Nation Media Group
“The Sh7.44 billion was requested but not provided for in supplementary estimates 1,” TSC chief executive Evaleen Mitei told the committee chaired by Tinderet MP Julius Melly during consideration of the Supplementary Estimates 1 for the financial year 2025/2026..
The proposed Supplementary Estimates 1 have increased the TSC’s allocation by Sh21.1 billion, raising it to Sh407.6 billion from the originally printed estimate of Sh386.5 billion for the financial year ending June 2026.
Teething challenges under the SHA emerged in February in the wake of a horrific road accident along Thika Road that claimed the lives of three teachers. And left several others seriously injured.
The Kenya Union of Post-Primary Education Teachers (Kuppet) condemned how some hospitals declined or delayed attending to injured teachers insisting that they pay cash.
The incident occurred when a 33-seater matatu lost control and rammed into the teachers outside City Primary School in Ngara where they had gathered to take part in the Kuppet branch elections.
Mr Duale noted that that aside from outright denial, some hospitals were claiming that their systems were down in a bid to discourage patients.
“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
According to the CS, SHA has so far released Sh15.4 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.
A tripartite meeting between Kuppet, the TSC, and the Ministry of Health (MoH) last week averted a potential teachers’ strike. The meeting addressed concerns over teachers being denied treatment in hospitals due to unpaid medical bills and clarified the accreditation status of medical facilities.
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 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.
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.
The meeting also agreed on the operationalisation of the last expense benefit, with SHA and TSC expected to establish a prompt and seamless claims process.
It has since been categorically clarified that the Group Life Cover and Work Injury Benefits Act (WIBA) provisions are not administered under the SHA.
Teachers have been guaranteed of a comprehensive maternity cover under SHA and sked to report any issues or denial for immediate action.
