NAIROBI, Kenya — Teachers in Kenya will no longer be required to make out-of-pocket payments when seeking treatment in public and contracted private hospitals, following a new agreement between the Ministry of Health, the Social Health Authority (SHA) and teachers’ representatives under the Public Officers Medical Scheme Fund (POMSF).
Health Cabinet Secretary Aden Duale said the government has directed that Level 5 and Level 6 hospitals, alongside other contracted facilities, must provide services to teachers without charging additional fees at the point of care.
“Teachers will not pay anything in hospital. Level 5 and 6 hospitals will fully take care of them under the scheme. That is the direction going forward,” Duale said.
The agreement follows weeks of complaints from teachers over disruptions linked to the rollout of SHA, including delayed approvals, system failures and reports of facilities demanding extra payments despite existing coverage.
Officials at the Social Health Authority acknowledged operational challenges during the transition, particularly around tariff controls that had created confusion among healthcare providers.
They said the tariff structures would be withdrawn immediately to restore smooth service delivery.
During the transition period, all contracted hospitals have been instructed not to charge teachers any co-payments while broader negotiations on tariffs continue nationwide.
Under the revised framework, SHA, the Teachers Service Commission (TSC) and teachers’ unions will hold monthly consultative meetings to monitor implementation, address emerging concerns and ensure compliance by healthcare providers.
The meetings are expected to focus on claims processing, hospital adherence to the scheme and service delivery standards.
The government has also pledged to improve efficiency in claims settlement and ensure continuity of care across accredited facilities.
Teachers’ representatives welcomed the move, describing it as a step towards restoring confidence in the medical scheme after a period of uncertainty.
“And we have for the last over one week, and now we are sure that this gesture and this agreement has restored our faith in SHA and in the leadership of the Ministry of Health and in the leadership of Waziri,” said the representative.
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“We will continue to work together. And I can assure teachers that we have actually got what we wanted from Waziri, and we are so grateful. Thank you so much.”
SHA said it will publish an updated list of contracted hospitals to guide teachers on where they can access services without delays or additional charges.
The reforms form part of a broader restructuring of healthcare provision for public officers, aimed at eliminating billing disputes, improving reimbursements to hospitals and strengthening service delivery.
While implementation challenges remain, stakeholders say the agreement marks a significant step towards stabilising the system and restoring trust among beneficiaries.
