Government, KNUT review progress of teachers’ medical cover transition to SHA

Health Cabinet Secretary Aden Duale has announced progress in the implementation of the Mwalimu Comprehensive Medical Cover under the Public Officers Medical Scheme Fund following a two-day consultative retreat bringing together the government, teachers’ unions and health agencies.

The retreat brought together officials from the Kenya National Union of Teachers (KNUT), the Teachers Service Commission (TSC) and the Social Health Authority (SHA) to assess progress made after teachers transitioned to the new health scheme.

In a statement issued after the meeting, Duale said the engagement reviewed the implementation of resolutions contained in a joint communique aimed at addressing challenges that had affected teachers’ healthcare coverage.

“Joined the Kenya National Union of Teachers (KNUT), the Teachers Service Commission (TSC) and the Social Health Authority (SHA) in concluding a two-day consultative retreat on the implementation of the Mwalimu Comprehensive Medical Cover under the Public Officers Medical Scheme Fund,” Duale said.

The Health CS highlighted several milestones achieved so far under the scheme, including the settlement of 35 Last Expense Benefit claims and the development of an Ex-Gratia Management Framework.

He added that teachers now have improved access to overseas treatment, with one teacher already receiving specialized medical care abroad.

“Notable milestones include the settlement of 35 Last Expense Benefit claims, development of an Ex-Gratia Management Framework, enhanced access to overseas treatment with one teacher already receiving specialized care abroad and the designation of four facilities to provide In Vitro Fertilization (IVF) services for teachers,” he said.

The government also revealed that negotiations with healthcare providers across the country are progressing as part of efforts to establish a harmonized and sustainable reimbursement system under the scheme.

According to Duale, several healthcare facilities have already finalized agreements with SHA, while an updated list of contracted facilities will soon be shared with KNUT leadership and published on the SHA website.

“Nationwide tariff negotiations with healthcare providers are also progressing well, with several facilities finalizing agreements to support a harmonized and sustainable reimbursement framework,” he stated.

Duale further directed SHA to operationalize joint county-level coordination structures involving KNUT and TSC officials within one week to strengthen service delivery and improve response mechanisms at the grassroots level.

“I further directed SHA to immediately operationalize joint county-level coordination structures with KNUT and TSC within one week to strengthen service delivery and response mechanisms at the grassroots level,” he said.

The retreat brought together 110 KNUT branch heads and 35 members of the National Steering Committee alongside senior government and union officials, including SHA Chief Executive Officer Dr. Mercy Mwangangi, Digital Health Agency CEO Eng. Anthony Lenaiyara, KNUT National Chairperson Patrick Karinga and Secretary General Collins Oyuu.

The meeting comes amid continued concerns from teachers over access to medical services following the transition to the new health insurance system, with stakeholders pushing for improved efficiency and expanded healthcare access across the country.