Why SHA declined to enroll over 360,000 teachers for health coverage – TSC CEO reveals
It has now become apparent that the Social Health Authority (SHA) declined to enroll over 360,000 teachers due to insufficient nationwide infrastructure.
According to the Teachers Service Commission (TSC) CEO Nancy Macharia, their attempts to onboard teachers into SHA were unsuccessful after being informed that the insurer lacked adequate structures throughout the country to accommodate the teachers.
While addressing the National Assembly Education Committee, Macharia informed the MPs that the Commission has consistently sought to enroll teachers into a public insurance scheme, but this aspiration has yet to be realized.
“Last year, when we encountered issues with Minet, we aimed to transition our teachers to SHA. Our intention to have our teachers covered by the national insurer has been persistent, even during the NHIF era,” she stated.
“We convened a meeting with SHA prior to renewing our contract with Minet for this final year, and they indicated that they did not possess enough structures. They noted that it would require Ksh. 37 billion to enroll our teachers, yet even then, they were not prepared to accommodate them this year,” she conveyed to the committee.
The gathering occurred in response to numerous complaints from teachers nationwide, who continue to experience difficulties due to a lack of medical attention, despite the Ksh. 20 billion contract that TSC signed with Minet to provide medical insurance for educators.
Committee Chairperson Julius Melly recounted a concerning case of a teacher who was placed in solitary confinement for three months for failing to settle a hospital bill — even though insured.
“What type of insurance coverage is this? It’s a mongrel; it lacks a coherent structure. You have an insurer, a lead consortium, an administrator, a capitator — it represents a very peculiar form of insurance. It is imperative to disengage from this arrangement,” stated Melly.
Luanda MP Dick Maungu advocated for teachers to be organized into clusters based on job group or region to expedite the approval process at health facilities, asserting that the current centralized mechanism is ineffectual.
“With Bliss Health Care acting as the primary capitator and considering the significant number of teachers involved, it becomes challenging for them to manage approvals in a timely manner — which is where the delays arise. Why is it not feasible to cluster teachers for efficiency? Presently, the system is overwhelmed,” Maungu observed.
Macharia, however, cited insufficient funding as a principal obstacle to offering comprehensive medical insurance, and urged the committee to allocate additional resources.
“If our teachers are to receive the highest quality of medical services, they must be adequately insured. However, we are unable to achieve this due to budgetary constraints. Additionally, we require timely disbursements to the consortium, as we frequently experience delays,” she remarked.
