- Evalyne Chepkirui Sanguya has raised concerns over SHA service capping, delayed authorisations and system failures affecting teachers’ access to medical care.
- Teachers have reportedly been forced to pay cash for services or leave facilities untreated after reaching benefit limits or encountering system failures.
- Sanguya has noted that KUPPET’s one-month ultimatum to the government has lapsed and has called on the National Governing Council to determine the union’s next course of action.
The Kenya Union of Post-Primary Education Teachers (KUPPET) Bomet Branch Gender Secretary Evalyne Chepkirui Sanguya has raised the alarm over mounting challenges facing teachers under the Social Health Authority (SHA) comprehensive medical cover, citing capping of services, delayed authorisations and system failures.
Sanguya said teachers continue to struggle accessing medical services despite making monthly contributions to the scheme. According to her, some teachers have been forced to pay cash for outpatient services after reaching prescribed limits, while others have allegedly been abandoned midway through treatment.
“The negotiated cappings are not working seamlessly as expected,” Sanguya said, expressing concern that teachers were being left to meet medical expenses out of pocket.
Delays in obtaining SHA authorisation have compounded the problem, with Sanguya saying some teachers have been forced to wait for hours or even days in hospital wards while seeking approval for treatment. She warned that such delays could expose patients with serious medical conditions to further complications as they wait for clearance to access critical services.
Sanguya also raised concerns that certain diagnostic services, including endoscopy, CT scans and ultrasound examinations, were not being captured on the SHA system in some accredited facilities. In such cases, she said, teachers were being asked either to pay cash for the services or leave the facilities without receiving the required treatment.
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She questioned the overall effectiveness of the system, noting that teachers remit their contributions consistently yet continue to face obstacles when they need medical care. “We remit our contributions every month without fail. But when we fall sick, we are told ‘the system is down’ or ‘not covered’,” she said.
Beyond the medical cover challenges, Sanguya also addressed the state of ongoing union engagement with the government, noting that the one-month ultimatum issued by the KUPPET National Executive Board (NEB) had lapsed.
She urged the National Governing Council (NGC) to communicate the union’s next course of action. “KUPPET NEB’s one-month ultimatum to the government has lapsed, and I urge the National Governing Council (NGC) to speak on the next course of action,” she said.
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Sanguya called for urgent intervention to resolve the challenges facing teachers under the SHA scheme, saying they deserve access to reliable and dignified healthcare without unnecessary delays or added financial burden. “This is not the healthcare we were promised. We serve this nation in classrooms. We deserve dignity in hospitals,” she said.
Her remarks come amid wider debate over the rollout of the SHA medical scheme, with workers and service providers across various sectors continuing to raise questions about authorisation processes, benefit limits and overall system efficiency. She urged authorities to act on the challenges raised and ensure the comprehensive cover delivers on the services promised to contributors.
By Phillip Koech
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