A New Era for Teacher Healthcare

NAIROBI, EAT – More than 400,000 Kenyan teachers and their dependents are set to be moved from their long-standing private medical insurance to the new state-run Social Health Authority (SHA) starting Friday, December 1, 2025. The transition marks a significant shift in public sector healthcare management, moving teachers from a scheme administered by a Minet Kenya-led consortium to the Public Officers' Medical Scheme Fund (POMSF), which is managed by SHA. The current Sh20 billion contract with Minet is scheduled to expire on November 30, 2025.

The move is part of the government's broader Universal Health Coverage (UHC) agenda, which aims to consolidate healthcare for all public servants under a single, national framework. The Social Health Authority, established under the Social Health Insurance Act of 2023, officially replaced the National Health Insurance Fund (NHIF) and began its operations on October 1, 2024. It manages three distinct funds: the Primary Healthcare Fund, the Social Health Insurance Fund (SHIF), and the Emergency, Chronic and Critical Illness Fund.

Union Reactions and Negotiations

The decision has been met with a mix of apprehension and cautious optimism from teachers' unions. Initially, the Kenya National Union of Teachers (KNUT) and the Kenya Union of Post Primary Education Teachers (KUPPET) voiced strong opposition, citing a lack of consultation and transparency from the Teachers Service Commission (TSC). Union leaders demanded full disclosure of the benefits package, a comprehensive list of accessible hospitals, and the inclusion of a group life insurance component before endorsing the switch.

Following a series of tense negotiations, a breakthrough was announced on Monday, November 10, 2025. After a meeting with the TSC and SHA officials, union leaders from KNUT, KUPPET, and the Kenya Union of Special Needs Education Teachers (KUSNET) formally agreed to the transition. TSC's Acting CEO, Evaleen Mitei, confirmed that a deal had been reached, assuring teachers that their concerns, including the removal of pre-authorisation hurdles and the inclusion of a group life cover, had been addressed.

However, dissent remains within the teaching fraternity. During the Kenya Primary School Heads Association (KEPSHA) annual conference in Mombasa, several headteachers protested the move, stating they were not adequately consulted. Some delegates expressed fear that the quality of care could diminish under a government-managed scheme, pointing to the challenges previously faced with the NHIF.

What the New SHA Scheme Offers

Proponents of the move argue that the SHA scheme will significantly expand healthcare access for teachers. The number of empanelled hospitals is set to increase from approximately 816 under Minet to over 9,000 facilities nationwide, including public, private, and faith-based hospitals. The new system also promises to automate admissions and discharges, aiming to eliminate the lengthy pre-authorisation delays that were a common complaint under the previous insurer.

The benefits package under SHA is designed to be comprehensive, covering:

• Inpatient and outpatient services
• Maternity care (up to Ksh 10,000 for normal delivery and Ksh 30,000 for a caesarean section)
• Dental and optical services
• Oncology and renal care (dialysis at Ksh 10,650 per session)
• Management of chronic illnesses
• Overseas treatment (up to Ksh 500,000 per year)
• Drug and substance abuse rehabilitation

The scheme will cover the principal member, one spouse, and up to five children. Dependents with disabilities will be covered irrespective of age.

Implications for Kenya's Public Sector

The migration of over 400,000 teachers to SHA is a critical test for the government's new healthcare financing model. For years, teachers have complained about the services under Minet, citing delays, limited hospital networks, and bureaucratic hurdles. The success or failure of this large-scale transition will have significant implications for teacher morale and could set a precedent for other public sector employees.

The TSC and SHA have reassured teachers of a seamless transition and better health packages. A joint technical committee involving the TSC and all teacher unions has been established to oversee the onboarding process and monitor the implementation of the new scheme. As the December 1 deadline approaches, all eyes are on whether the Social Health Authority can deliver on its promise of providing accessible, quality, and efficient healthcare to Kenya's educators.