Teachers’ Health Cover in Crisis: SHA System Glitches Leave Educators Denied Care

What was billed as a “new era” of healthcare for Kenya’s 415,000 teachers is rapidly turning into a nationwide crisis. Two months after the mandatory shift from the private Minet (AON) scheme to the state-run Social Health Authority (SHA), teachers are reporting widespread service denials, administrative delays, and frustration.

On December 1, 2025, the Teachers Service Commission (TSC) officially ended its decade-long partnership with Minet, migrating teachers to the Public Officers Medical Scheme Fund (POMSF) under SHA. 

The government touted a network of over 9,000 hospitals, a massive increase from the previous 800 facilities.

But reports from Nakuru to Likoni tell a different story. Teachers say they are being turned away at private and faith-based hospitals, citing system verification errors and pre-authorization failures. 

A recent Thika Road accident highlighted the flaws, as several injured teachers were denied emergency care despite SHA policy guaranteeing first 24 hours treatment.

Union leaders, including the Kenya Union of Post-Primary Education Teachers (KUPPET), have condemned the rollout, calling the initiative a failure. Issues include:

Technical Glitches: Missing OTPs and mismatched data leave teachers unable to prove eligibility.

Unsettled Debts: Private facilities hesitate to offer services due to unpaid claims inherited from NHIF and the transition period.

Benefit Dilution: High theoretical limits, such as KSh 1.3 million inpatient cover for senior teachers, remain inaccessible due to manual approvals and lack of “smart cards.”

The crisis has also sparked internal divisions within the teaching community. Grassroots members accuse union elites of prioritizing themselves, with many still covered by private insurers like Britam.

SHA CEO Dr. Mercy Mwangangi urges patience, insisting the system is stabilizing, highlighting air evacuation, chronic illness management, and addiction rehabilitation as new benefits.

With mandatory 2.75% deductions appearing on payslips and unions threatening strikes, the SHA-run “Mwalimu Cover” faces its most critical test yet.