Teachers in Kenya are demanding the reinstatement of their medical allowance, expressing apprehension about the impending transition to the Social Health Insurance Fund (SHIF). Educators from Nyeri and Murang'a counties, speaking at a press conference on Wednesday, October 8, 2025, voiced concerns that a full shift to SHIF could compromise their access to quality and specialised healthcare, particularly in public hospitals.

Antony Gitonga, a teachers' representative, stated that if the transition to SHIF proceeds, the medical allowance must be reinstated to enable teachers to seek specialised treatment in private facilities where such services may not be readily available in public hospitals. He highlighted existing challenges under the current MINET medical scheme, noting that many female teachers already struggle to access specialised care due to a lack of specialists in designated hospitals.

Historical and Political Context

The concept of a medical allowance for teachers and civil servants dates back to 2003, introduced during the first Kibaki administration to supplement the limited coverage of the then-National Health Insurance Fund (NHIF). In 2015, this allowance was converted into a comprehensive medical cover administered by a consortium of insurance companies led by Minet Kenya Insurance Brokers. This scheme has since grown significantly, with the annual allocation increasing from KSh 6 billion to KSh 20 billion as the number of teachers expanded to over 400,000, covering approximately 1.3 million individuals including dependents.

However, the current MINET scheme has faced criticism, with reports of hospitals turning away teachers due to delayed remittances of medical capitation funds from the National Treasury since September 2024. This has forced teachers to pay for services out-of-pocket or face detention in hospitals.

Laws, Policy, and Governance

The Social Health Insurance Fund (SHIF) is set to replace the National Hospital Insurance Fund (NHIF) as Kenya's primary health insurance scheme. The Social Health Authority (SHA) was established under the Social Health Insurance Act, No. 16 of 2023, with SHIF scheduled to commence operations on October 1, 2024. Employers were required to register their employees and their dependents with SHA through the SHA Employer Portal by October 1, 2024.

Under SHIF, salaried employees are to contribute 2.75% of their gross salary monthly, with a minimum contribution of KSh 300 and no maximum limit. For non-salaried individuals, households will contribute 2.75% of their total household income annually, with a minimum monthly contribution of KSh 300.

Stakeholders and Testimonies

Teachers' unions, including the Kenya National Union of Teachers (KNUT) and the Kenya Union of Post-Primary Education Teachers (KUPPET), have been vocal in their demands. KUPPET Deputy Secretary General Moses Nthurima previously called for the immediate release of over KSh 11 billion in medical capitation funds owed to hospitals, highlighting the crisis faced by teachers. Union leaders met with President William Ruto on Monday, September 9, 2025, where the President reportedly agreed to retain and review the teachers' medical scheme, acknowledging the inadequacy of current packages.

Despite this, teachers remain concerned about the transition to SHIF, particularly regarding the limited number of empaneled healthcare facilities under SHA, many of which are public hospitals perceived as under-serviced and lacking specialists. They advocate for the inclusion of private hospitals to ensure broader access to quality care.

Evidence and Data

The Teachers Service Commission (TSC) has announced a deadline of December 1, 2025, for moving teachers from the MINET-managed medical cover to the Public Officers' Medical Scheme Fund under SHA. The current MINET contract is set to expire on November 30, 2025, and will not be renewed.

Risks and Implications

The rushed transition to SHIF without adequate preparation and clarity on benefits could leave over 400,000 teachers and their dependents with compromised healthcare services. Concerns persist about the capacity of SHA to handle pre-authorization processes for such a large membership and to mitigate delayed payments to healthcare facilities, a problem that has plagued the current system.

Unknowns and Controversies

While the government has indicated a new comprehensive medical insurance scheme for civil servants, teachers, and public officers will run alongside SHIF, there are fears of additional deductions from payslips. The proposed scheme would require members to exhaust their SHIF accounts before accessing benefits from the Public Officers' Medical Scheme.

Timeline and Next Steps

The transition from NHIF to SHIF officially began on October 1, 2024. The TSC aims to onboard teachers to the new scheme under SHA by December 1, 2025. A technical committee comprising representatives from TSC, the Ministry of Education, teachers' unions, and headteachers' associations is tasked with designing the enhanced benefits structure.

What to Watch

Stakeholders will be closely watching the finalisation of the framework for the Public Officers' Medical Scheme Fund and the resolution of concerns regarding its integration with SHIF. The ongoing consultations between the TSC, teachers' unions, and other government agencies will be crucial in ensuring a seamless transition and addressing the teachers' demands for adequate medical coverage.