The Social Health Authority, Ministry of Health Kenya, and the Kenya National Union of Teachers have reached an agreement on wide-ranging changes aimed at fixing disruptions affecting teachers’ medical cover under the Public Officers Medical Scheme Fund, in an effort to restore services and prevent a nationwide strike.
In a joint statement after a high-level meeting held on Tuesday, the three parties announced new measures that include payment of last expense benefits, access to specialised treatment abroad, and a strict ban on any out-of-pocket payments for teachers seeking medical care.
“We jointly reaffirm our unwavering commitment to the health, dignity, and well-being of the Kenyan teacher,” the statement read.
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Under the new arrangement, the last expense benefit has been fixed at Sh300,000. According to the agreement, 160 claims have already been processed, with payments scheduled to start on April 29, 2026.
“A prompt and seamless claims process has been established… the benefit is confirmed and payable at a rate of Sh300,000,” the parties said.
The deal also introduces an Ex-Gratia Management Framework meant to support teachers facing high medical costs that go beyond normal cover. Under this system, teachers will submit written requests, which will be approved by the Teachers Service Commission while the Social Health Authority handles payments.
In another major shift, teachers will now be allowed to seek specialised treatment outside the country in contracted hospitals in Turkey, India and Saudi Arabia. The authority confirmed that arrangements are already in place and patients have begun accessing the service.
“SHA has finalized the contracting of overseas facilities to provide specialized, life-saving interventions… the first patient is leaving tonight,” the statement noted.
The agreement also expands cover to include In Vitro Fertilization services at selected facilities within Kenya, widening access to fertility treatment for teachers under the scheme.
Health Cabinet Secretary Aden Duale chairs a consultative engagement with the Kenya National Union of Teachers (KNUT) at Afya House, Nairobi, April 28, 2026. PHOTO/MOHTo address long-standing complaints from health providers, the Social Health Authority announced the removal of tariff locking, a system that had limited payments to hospitals and clinics.
At the same time, the parties imposed a strict directive on medical facilities handling teachers under the scheme.
“All health facilities… are strictly prohibited from charging any teacher any out-of-pocket fees or co-payment,” the communiqué stated, pending completion of nationwide tariff negotiations.
The tariff talks will run for four weeks and will involve 3,566 private and faith-based health facilities across the country. The goal is to agree on standard prices and improve service delivery under a system expected to operate on a “walk-in, walk-out” basis with no extra charges for teachers.
The agreement comes amid growing pressure from teachers, who had threatened a nationwide strike over delays in service delivery, treatment denial, and payment challenges under the new medical scheme.
To maintain dialogue, the parties agreed to convene a joint National Executive Council meeting within two weeks. County-level structures will also be revived to handle grievances at local level and reduce escalation of disputes.
The Social Health Authority further committed to publish a full list of contracted health facilities and roll out stricter cost controls, including routine audits and quarterly reviews, aimed at improving accountability and safeguarding public funds while ensuring reliable healthcare for teachers.
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