SHA Under Fire as Teachers Struggle to Access Medical Care

Teachers in the country say they are being forced to pay for medical treatment out of their own pockets despite contributing monthly to health insurance under the Social Health Authority (SHA).

One month after the government promised to print and distribute health insurance cards for teachers, the situation appears very different. Teachers are now facing new hospital service charges that require them to top up from their own money in order to receive treatment.

A teacher in Nairobi said he was shocked after undergoing a minor eye surgery at Westlands Laser Eye Hospital, where the total bill was Sh12,000. SHA agreed to cover only Sh4,500.

“I was shocked when I was told SHA would only pay Sh4,500. When I tried calling for help, I was passed around with no answers,” he said.

Teachers suffering from chronic illnesses say the situation is even worse. A teacher in Nakuru living with high blood pressure and diabetes said he now has to pay for his own medication after SHA covered only Sh1,200.

Teachers’ unions have strongly criticized the system and are calling for urgent reforms to rescue teachers.

KNUT Nakuru branch secretary Antony Gioche said many teachers are being forced to pay cash despite having insurance.

“For those with chronic illnesses, the situation is even worse,” he said.

The government, through SHA, said the new rates are part of the implementation of the Public Officers Medical Scheme Fund (POMSF). SHA Chief Executive Officer Dr. Mercy Mwangangi said discussions with various hospitals are ongoing to harmonize the charges.

However, teachers say there has been no direct communication about the changes, causing confusion when they visit hospitals.

KNUT Nyandarua branch secretary Charles Njau said the current system cannot work because too much money is spent on tests, leaving very little for treatment.

Meanwhile, KUPPET West Pokot branch secretary Alfred Kamuto said many teachers are unable to access treatment when they need it and called for the return of the previous Minet medical scheme.