360,000 Teachers Can’t Access SHA Services- TSC
The issue of access to healthcare, which affects over 360,000 teachers and their dependents under the Teachers Service Commission (TSC) medical scheme, remains unresolved, as the Social Health Authority (SHA) has declined to incorporate them due to insufficient capacity and significant cost implications.
In her address before the National Assembly’s Education Committee, TSC Chief Executive Officer Nancy Macharia disclosed that, although the government allocated Sh20 billion for the medical coverage of teachers, SHA stated that it would necessitate Sh37 billion to accommodate the beneficiaries.
“This funding deficit additionally impacted the former National Health Insurance Fund (NHIF), which prompted us to renew our contract with Minet Insurance,” Macharia remarked.
The Commission entered into a three-year agreement with Minet, effective from December 1, 2022, through November 2025.
“Last year, when challenges arose with Minet, our aim was to transition our teachers to SHA. We have consistently sought for our teachers to benefit from the national insurer, even during the period of NHIF,” she continued.
“However, SHA informed us that they lacked the requisite infrastructure and required Sh37 billion to assume control of the scheme, which we currently manage with Sh20 billion. That represents our impasse. ”
The Minet-administered scheme has faced significant criticism from lawmakers, who characterized it as a “mongrel system” that fails to provide prompt and efficient healthcare services to teachers and their families.
Igembe North MP Julius Taitum raised concerns regarding the integrity of the tendering process, implying that the absence of competing bidders might be a tactic to sustain a monopoly.
“You indicated that no other insurance companies submit bids during tendering. Is this due to the current handlers mismanaging the scheme to deter competition? Are they undermining the process to remain unchallenged? ” he questioned.
Teso South MP Mary Emase made a fervent appeal, sharing real-life accounts of teachers encountering extensive delays or outright denial of care owing to sluggish approvals.
“I am aware of a teacher whose approval from Minet was postponed until we had to intervene through agents. In Bungoma, teachers are compelled to wait for hours in hospital lobbies. Some are even accused of feigning illness merely to obtain care,” Emase expressed with dismay.
Committee Chair Julius Melly resonated with the frustrations, describing the medical scheme as dysfunctional and structurally inadequate. He referenced a scenario in which a teacher was held in a hospital for three months due to delayed payments, with Minet only settling the bill following sustained pressure.
“We have documented instances where teachers are confined in hospitals for months because the school is not recognized as a service provider. That is unacceptable,” Melly stated.
He urged the TSC to discard the existing consortium-based model and consider decentralized, competitive alternatives.
“You should allocate teachers among several reputable insurers. What you currently possess is a disorganized system that is chaotic and ineffective,” he asserted.
Luanda MP Dick Maungu condemned the centralized approval model, attributing it as the cause of persistent delays. He suggested a cluster-based approach to enhance service delivery and alleviate the burden on central administrators.
“Given that Bliss Healthcare is responsible for managing approvals for all educators, it is not surprising that there are widespread delays. Why not consider dividing them into smaller, manageable groups? ” Maungu suggested.
Baringo North MP John Makilap cautioned that unless substantial modifications are implemented prior to the contract’s expiration in November 2025, educators will continue to endure hardships under the current arrangement.
“This initiative is ambiguous and inadequately structured. If we do not reorganize it—either by segmenting teachers into cohorts or transitioning them to SHA—it will perpetually fail them,” he stated.
Taitum advocated for a comprehensive investigation into the consortium’s operations, contending that it is acting contrary to the interests of teachers.
“This arrangement is denying equity to our teachers. It constitutes a collective of insurers acting in unison, and it is imperative that we conduct a full-day session to interrogate them and determine a path forward,” he asserted.
Nevertheless, TSC Director of Legal Services Cavin Anyour defended the current model, asserting that it represents the most optimal option available within the private sector.
“At the time of bidding, Minet collaborated with a consortium of eight leading medical insurers. They are the foremost providers in the country, and each has a distinct role. They absorbed all capable firms, excluding the smaller entities that lacked capacity,” Anyour elucidated.