The Social Health Authority (SHA) has responded to claims by the Teachers Service Commission (TSC) that it declined to enroll over 360,000 teachers, due to lack of nationwide infrastructure.
TSC CEO Nancy Macharia, while appearing before the National Assembly Education Committee stated that efforts to onboard teachers into the SHA scheme failed after they were informed that the Authority lacked sufficient structures across the country to cater for teachers.
She added that although TSC has always wanted to enroll teachers into a public insurance scheme, it has not been possible so far.
“Last year, when we had issues with Minet, we wanted to move our teachers to SHA. We have always wanted to have our teachers under the national insurer, even during the NHIF days,” she said.
However, according to SHA, all teachers and their dependents are eligible for the Social Health Authority (SHA) benefits package under the three Funds.
These includes the Primary Healthcare Fund (PHC), Social Health Insurance Fund (SHIF) and Emergency, Critical & Chronic Illness Fund (ECCIF) like any other Kenyan who is registered and contributing.
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SHA Says It Does Not Manage TSC Complementary Medical Cover
The authority mentioned that employers such as TSC can provide complementary insurance for their employees for additional benefits through a valid insurance underwriter.
SHA emphasized that this supplementary coverage is managed separately from the services it provides.
“The Social Health Authority does not manage the TSC complimentary medical cover which they got from a private insurance provider,” read the statement in part.
Nonetheless, SHA stated that TSC can enroll its members in the public officers’ medical scheme fund, in which they’ll determine the complimentary benefits based on its budget.
Macharia Says Authority Cited Ksh17 billion Shortfall
Nancy Macharia told the National Assembly Education Committee on that although the government had allocated Ksh20 billion for the medical scheme, SHA insisted it required Ksh37 billion to absorb the teachers.
“We held a meeting with SHA before renewing our contract with Minet for this final year, and they told us they didn’t have enough structures. They said they would need Ksh.37 billion to enroll our teachers, but even then, they were not ready to take them on this year,” she told the committee.
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Committee Chairperson Julius Melly narrated a troubling case of a teacher who was placed in solitary confinement for three months for failing to clear a hospital bill — despite being insured.
“What kind of insurance cover is this? It’s a mongrel; it has no head or tail. You have an insurer, a lead consortium, an administrator, a capitator — it’s a very funny type of insurance. You must get out of this thing,” said Melly.
TSC renewed its three-year contract with Minet Insurance in December 2022, which is set to run until November 2025.
However, the Minet-administered scheme continues to face criticism over poor service delivery, inefficiencies and delays.
According to SHA, there are 21.6 million Kenyans who have registered with SHA and an average number of 50,000 Kenyans register daily.
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