Teachers across the country will now access medical services of up to Sh10,000 per day following high-level talks in Naivasha between the Kenya Union of Post-Primary Education Teachers (KUPPET) and Health Cabinet Secretary Aden Duale.
The meeting, held to address concerns over the Social Health Authority (SHA) scheme, resulted in a key adjustment of the outpatient medical cap, offering relief to thousands of teachers who had complained about limited access to healthcare.
Speaking after the meeting, Duale said the government had taken into account concerns raised by teachers and was committed to ensuring the system delivers accessible and affordable healthcare.
“We have agreed on adjustments that will ensure teachers have access to services without unnecessary financial strain. The government is focused on making the system work effectively,” he said.
The revised Sh10,000 daily limit marks a significant improvement from the previous cap of about Sh1,200 per outpatient visit, which had drawn criticism from teachers who argued it was too low to cover basic treatment.
KUPPET Secretary General Akello Misori welcomed the outcome, noting that the move would ease the burden on teachers who had been forced to pay out of pocket under the previous arrangement.
“This adjustment is a major relief to teachers who have struggled to access healthcare under the previous limits,” said Misori.
He said the union would continue to monitor the implementation to ensure the changes are reflected at health facilities across the country.
“We will closely follow up to ensure teachers receive the services they deserve without additional costs,” he added.
Key Resolutions from Naivasha Talks
In a joint consultative session bringing together KUPPET, the Teachers Service Commission (TSC) and the Social Health Authority (SHA), stakeholders concluded a two-day retreat aimed at strengthening healthcare access under the Mwalimu Comprehensive Medical Scheme.
According to Duale, the engagement delivered targeted solutions to address service delivery challenges affecting teachers.
“We have restored the co-payment structure to its original status and eliminated unauthorized out-of-pocket charges by facilities,” Duale said.
Non-compliant health providers have been placed under review as part of enforcement measures.
The meeting also resolved issues around overseas treatment, which has now been fully formalised and operational, expanding access to specialised care for teachers.
To improve efficiency, a region-based network of contracted healthcare providers has been established, while access to prescribed medication, especially for chronic conditions, has been enhanced to ensure continuity of care.
“Teachers managing chronic illnesses will now receive a full one-month supply of medication to ensure continuity of care,” Duale stated.
Additional Reforms Announced
Duale further confirmed that the Last Expense Benefit under the scheme is now fully operational, with a payout of Sh300,000 upon the death of a principal member.
Initial claims have already been processed, with future payments expected to be settled within 48 hours.
The government has also institutionalised the Ex-Gratia Management Framework, finalised the contracting of overseas facilities, strengthened regional engagement for faster response, planned the rollout of National Ambulance Services, and proposed new referral hospitals in Bungoma, Kericho and the Coast region.
“These structured engagements are strengthening a responsive and trusted system as we advance Universal Health Coverage,” Duale added.
Background
The dispute emerged following the rollout of the Social Health Authority (SHA), which replaced the previous medical scheme for teachers. Concerns over low caps, limited coverage, and rising out-of-pocket expenses had triggered protests and threats of industrial action.
The latest agreement is expected to ease tensions within the education sector and restore confidence in the teachers’ medical scheme.
By Joseph Mambili
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