TSC CEO Explains Why SHA Rejected Over 360,000 Teachers from Health Scheme.
Over 360,000 teachers were denied enrolment into the Social Health Authority (SHA) insurance scheme due to inadequate infrastructure nationwide, it has now been revealed. The Teachers Service Commission (TSC) had pushed for the move, but the effort was thwarted by SHA’s inability to support such a vast number of beneficiaries across the country.
Appearing before the National Assembly Education Committee, TSC CEO Nancy Macharia explained that the Commission had sought to transition teachers to SHA after facing challenges with their current provider, Minet. She emphasized that their goal has always been to bring educators under a public insurance scheme, dating back to the National Hospital Insurance Fund (NHIF) era.
Macharia disclosed that before the final renewal of their contract with Minet, a meeting was held with SHA officials who openly admitted their limitations. They informed TSC that they would require Ksh.37 billion to accommodate teachers under their coverage and still wouldn’t be able to onboard them within the year. “We met SHA before renewing Minet’s contract,” Macharia told the committee. “They said they lacked enough structures and wouldn’t manage this year.”
Teachers Still Suffer Under Existing Insurance
The committee’s probe was prompted by increasing dissatisfaction from teachers across Kenya, who report continued struggles in accessing medical services despite the existing Ksh.20 billion deal with Minet. Many educators have complained of delays, lack of approvals, and limited service delivery under the current insurance setup.
Committee Chairperson Julius Melly shared a distressing example of a teacher detained in isolation for three months due to unpaid hospital bills. He strongly criticized the structure of the insurance, calling it confusing and ineffective. “This is a mongrel system — it has no head or tail. There’s an insurer, a lead consortium, an administrator, and a capitator. It’s a very funny kind of insurance,” he said bluntly. “You must get out of this thing.”
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Luanda MP Dick Maungu proposed reforms, suggesting that teachers be grouped by job category or geographical location to streamline approval processes at health facilities. He argued that the centralized model currently in place is failing. “With Bliss Health Care as the master capitator and the sheer volume of teachers, it’s hard for them to manage timely approvals. The system is simply overwhelmed,” Maungu stated.
Macharia acknowledged these challenges and reiterated the need for improved funding. She appealed to the committee to allocate more resources and ensure timely payments to the consortium managing the teachers’ insurance. She noted, “To deliver proper medical care to our teachers, they must be comprehensively insured. But we can’t do that without enough funds and timely disbursements — that’s where we face delays.”
TSC CEO Explains Why SHA Rejected Over 360,000 Teachers from Health Scheme.
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