Duale assures teachers of uninterrupted healthcare under SHA

The Ministry of Health has assured teachers that the newly rolled-out Public Officers Medical Scheme Fund (POMSF) is fully operational and providing healthcare services without disruption.

In a statement, Health CS Aden Duale addressed concerns raised by teachers’ unions regarding the transition to the Social Health Authority (SHA), saying: “We wish to categorically assure our teachers, and the general public, that there is absolutely no cause for alarm."

“The POMSF, administered under the Social Health Authority (SHA), is not only fully operational but is performing exceptionally well, ensuring that the health needs of our educators are met without disruption,” he added.

Duale also dismissed claims that teachers were being turned away or denied treatment, saying available data shows significant uptake of services under the scheme.

“To set the record straight and dispel any narrative suggesting that teachers are being turned away or denied care, the data speaks for itself. As of our latest performance review, over 249,000 teachers and their dependents have successfully been seen and treated across the country, with current claims standing at over KES 3.5 billion,” said Duale.

According to the ministry, the new scheme allows teachers greater flexibility in choosing healthcare providers compared to previous arrangements.

“Unlike the restrictive, tiered networks of the past, teachers now enjoy unparalleled choice and accessibility. To date, teachers have confidently sought and received care in 2,823 different health facilities.”

So far, the ministry says, Nairobi County leads in claims under the scheme, with 30,766 claims totaling Sh527.7 million, followed by Uasin Gishu County with 29,212 claims totaling Sh463.2 million.

Meru and Bungoma counties have recorded 34,189 and 29,743 claims, respectively, totaling Sh243.8 million and Sh237.6 million.

Other counties with high utilisation of the cover include Kisii, Kisumu, Nakuru, Kiambu, Trans Nzoia and Kericho, with teachers accessing services in both public and private health facilities across the country.

According to Duale, the new framework marks a shift from the previous private insurance model, which he said had several shortcomings.

“We must contextualize this transition. For years, teachers were placed under private insurance arrangements that were plagued by opaque administrative limits, highly inflated premium costs, and restricted access that often left them stranded at the hour of need,” said the CS.

He added that the new scheme eliminates intermediaries and ensures government funds directly support healthcare services for teachers and their dependents.

“The POMSF under SHA represents a fundamental shift. We have eliminated the profit-driven middlemen. This new framework ensures that every shilling allocated by the Government goes directly into purchasing quality healthcare for the teacher and their dependents, rather than funding administrative overheads and inflated private margins,” he said.

The statement follows a warning by KUPPET, which demanded that the ministry address teachers' medical cover concerns within seven days or face industrial action.

According to Duale, the ministry is working closely with the Teachers Service Commission (TSC) and the Social Health Authority to monitor the rollout of the scheme and address any emerging challenges.

“The Ministry, in collaboration with the Teachers Service Commission (TSC) and the Social Health Authority, is continuously monitoring the system in real-time. Any isolated teething hitches are being resolved instantly to ensure zero disruption to service delivery,” he said.

“We urge all teachers to continue utilising the SHA-contracted health facilities available to them across the country with full confidence. The Government remains steadfast in its commitment to protecting the health and dignity of the Kenyan teacher.”