The Social Health Authority (SHA), one of President William Ruto’s flagship healthcare reforms, is once again under fire — this time for failing to enrol more than 360,000 teachers into its national insurance scheme due to lack of infrastructure.
The SHA was established under the Social Health Insurance Act, 2023, with the promise of delivering affordable, quality healthcare to all Kenyans through a unified insurance platform.
However, from its inception, the initiative has been dogged by controversy, ranging from irregular procurement claims to fears over sensitive health data falling into the hands of foreign-owned system providers.
Now, its credibility has been further shaken after Teachers Service Commission (TSC) CEO Nancy Macharia revealed that the Authority had turned away their attempts to enrol teachers, citing insufficient structures nationwide to handle the task.
Appearing before the National Assembly Education Committee, Macharia explained that the TSC has long sought to transition educators into a public health insurance plan — a goal that has faced repeated setbacks, even during the days of the National Hospital Insurance Fund (NHIF).
“Last year, when we had difficulties with Minet, we considered moving teachers to SHA. We’ve always wanted our teachers under a national insurance scheme,” Macharia told MPs.
“But in a meeting with SHA before renewing our final-year contract with Minet, they informed us they lacked the capacity. They would need Ksh.37 billion for the enrolment, and even then, weren’t ready to take them on this year.”
The disclosure comes amid growing frustration from teachers nationwide, many of whom complain about inadequate medical attention despite TSC’s Ksh.20 billion contract with Minet to cover their health insurance needs.
Committee Chairperson Julius Melly recounted a distressing case of a teacher confined to a hospital’s isolation unit for three months after being unable to settle a bill — despite being insured.
“What kind of insurance cover is this? It’s a mongrel with no head or tail. You’ve got an insurer, a lead consortium, an administrator, a capitator — it’s all a confusing mess. You need to get out of this arrangement,” Melly criticized.
Luanda MP Dick Maungu proposed clustering teachers based on job groups or regions to streamline the approval process at health facilities, arguing that the centralized system is currently overwhelmed.
“With Bliss Health Care as the main capitator and thousands of teachers under its belt, approvals are too slow. Why not create clusters to ease the pressure? The delays are affecting lives,” Maungu stated.
Macharia, however, pointed to chronic underfunding as a key obstacle in offering comprehensive, efficient medical insurance for teachers, and appealed to lawmakers for increased budget allocations.
“For our teachers to get quality healthcare services, we need full insurance cover — but we simply don’t have the resources. Timely disbursements to the consortium are also a challenge, with frequent delays hurting service delivery,” she added.
Every Kenyan has a right to health. And for the teachers currently making monthly payments to SHA without getting their right to health, this will certainly not be fair to them.
