The Kenyan government has moved to reassure teachers about continued access to healthcare services under the new public medical cover, maintaining that the system is functioning effectively despite criticism from a section of teachers’ unions.
Health Cabinet Secretary Aden Duale said the Public Officers Medical Scheme Fund (POMSF), administered by the Social Health Authority (SHA), remains fully operational and is already supporting hundreds of thousands of teachers and their dependents across the country.
The reassurance follows a warning from the Kenya Union of Post-Primary Education Teachers (KUPPET), which announced plans to withdraw from the scheme and issued a seven-day strike notice over what it described as systemic failures affecting teachers seeking medical care.
Union Raises Concerns Over Access and Funding
KUPPET officials claim that the new system has been plagued by technical breakdowns, a limited number of hospitals accepting the cover, and insufficient funding allocations for certain services, particularly accident and emergency care.
The union further alleged that some teachers have been denied treatment at healthcare facilities, while others were reportedly detained in hospitals due to unpaid medical bills.
These concerns have heightened tensions between educators and the government as the new healthcare framework continues its rollout.
Government Cites Data Showing Widespread Utilization
However, CS Duale dismissed the allegations, stating that data from the Ministry of Health indicates strong uptake of the medical scheme since its launch.
According to ministry figures, more than 249,000 teachers and their dependents have already received treatment under the program. Claims processed so far exceed Ksh.3.5 billion, demonstrating what the government describes as effective service delivery.
Teachers have reportedly accessed healthcare services in 2,823 public and private medical facilities across the country under the SHA network.
Counties Recording the Highest Claims
Data released by the ministry shows that Nairobi County recorded the highest number of claims, with 30,766 cases worth Ksh.527.7 million.
Other counties with significant utilization include:
- Uasin Gishu: 29,212 claims valued at Ksh.463.2 million
- Meru: 34,189 claims totaling Ksh.243.8 million
- Bungoma: 29,743 claims worth Ksh.237.6 million
Additional counties reporting high usage include Kisii, Kisumu, Nakuru, Kiambu, Trans Nzoia, and Kericho.
Shift From Private Insurance Model
The government says the new arrangement represents a significant departure from the previous private insurance-based system that handled teachers’ healthcare.
According to Duale, the earlier model was characterized by opaque administrative limits, inflated premiums, and restricted access to services.
Under the new framework, the government argues that funds are directed straight into healthcare delivery rather than administrative costs and private insurance margins.
“We have eliminated the profit-driven middlemen,” Duale said, adding that the current system aims to provide broader and more equitable access to healthcare services for teachers and their families.
Government Monitoring Implementation
Authorities say the rollout of the scheme is being closely monitored by the Ministry of Health in collaboration with the Teachers Service Commission and the Social Health Authority.
While acknowledging that the transition may have experienced isolated operational challenges, the government insists that corrective measures are being implemented in real time to prevent disruptions.
CS Duale urged teachers to continue seeking treatment at SHA-contracted healthcare facilities nationwide, emphasizing the government’s commitment to protecting the health and welfare of educators.
