The Kenya Union of Post-Primary Education Teachers (KUPPET) has issued a seven-day ultimatum to the Social Health Authority (SHA) to resolve persistent problems in the management of teachers’ medical cover, warning that failure to act could force members to withdraw from the scheme.
The union says that repeated system failures, limited hospital participation, and inadequate allocations for Accident and Emergency services have left teachers struggling to access healthcare.
The situation has worsened since the shift to SHA’s Mwalimu Cover on December 1, 2025.
KUPPET Secretary General Akelo Misori said the current system is collapsing, with hospitals in Nairobi halting services due to a strained claims process and an overburdened pre-authorisation system.
“We have been having a medical cover which did not compel us to come to hospitals to establish pay bill numbers for contribution or to raise funds in County halls. But what is happening now is not supposed to be what the teachers are supposed to undergo. In Nairobi alone, the hospitals are withdrawing because the system of claims is fatigued. The system of pre-authorisation is also fatigued,” he said.
He added that if the situation continues, the health and safety of teachers who contribute heavily to SHA will be at risk.
KUPPET National Chairman Omboko Milemba said teachers have resorted to harambees to meet medical expenses, with members already raising Sh1.5 million alongside the union.
“This is something we have never seen in the last 16 years, and therefore, SHA is not working for teachers. We are back to raising funds, and somebody should hear us. We are back to Harambee so that a teacher can access a hospital, and we will not accept that,” he said.
Milemba further warned that if SHA cannot run the scheme efficiently, teachers will pull out, giving the authority a seven-day window to address the issues.
“If SHA cannot manage teachers’ medical cover, then they should step aside. And if they do not, we will withdraw from it. As the Secretary General has said, we are giving them only seven days,” he said.
The transition to SHA’s Mwalimu Cover followed the end of Medical Administrators (K) Limited’s (MAKL) contract, which had previously handled the Teachers Service Commission’s health insurance. Hospitals were instructed to stop serving teachers from midnight on November 30, citing the contract’s expiration.
SHA’s Mwalimu Cover provides a wide range of benefits, including inpatient and outpatient care, maternity services, chronic disease management, dental and optical care, road and air evacuation, last expenses, and overseas treatment.
Coverage includes principal members, one declared spouse, and up to five children aged 0–21, or up to 25 if they are full-time students. Children with disabilities registered with the National Council for Persons with Disabilities are also covered.
