The Ministry of Health (MoH), the Social Health Authority (SHA), and the Kenya National Union of Teachers (KNUT) held a joint consultative meeting to address operational challenges affecting the transition of the teachers’ medical cover to the Public Officers Medical Scheme Fund (POMSF).
In a communiqué issued on 28 April 2026, the parties confirmed that they had agreed on key resolutions to improve service delivery and restore stability within the scheme.
“Following highly successful tripartite deliberations, we jointly reaffirm our unwavering commitment to the health, dignity, and well‑being of the Kenyan teacher,” the statement read in part.
SHA Announces Immediate Withdrawal of Tariff LockingÂ
SHA has announced the immediate withdrawal of tariff locking currently configured in the system under the POMSF.
According to SHA, the implementation of any locked tariffs will only take effect after comprehensive negotiations with healthcare providers and validation through county-level forums involving KNUT members who have signed agreements with the authority.
“SHA will immediately withdraw the tariff locking currently configured in the system. Locked tariffs shall only be implemented after comprehensive negotiations concluded exclusively with healthcare providers and validated in each county forum consisting of KNUT members who have signed tariffs with SHA,” the Ministry of Health statement.
During the interim period, all health facilities offering POMSF services are prohibited from charging teachers any out-of-pocket fees or co-payments.
SHA has also outlined plans for targeted nationwide tariff negotiations to be completed within four weeks, beginning 28 April 2026.
The exercise will cover all Level 3 to Level 6 private and faith-based health facilities across the country, totaling 3,566 facilities.
SHA, MoH, and KNUT Resolve Key Benefit Administration
In the statement, MOH, SHA, and KNUT confirmed resolution of key benefit administration issues under the Public Officers Medical Scheme Fund (POMSF), according to a joint communiqué issued on 28 April 2026.
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The Last Expense Benefit has been formalized at KES 300,000 for deceased principal members, with 160 claims already processed and payments scheduled for release on 29 April 2026.
An Ex-Gratia Management Framework has been instituted to support teachers with medical costs exceeding standard cover, with applications processed through TSC and payments executed by SHA upon approval.
SHA has also contracted overseas medical facilities in Turkey, India, and Saudi Arabia for specialized treatment, with access guidelines published by SHA and TSC.
Additionally, the scheme confirms coverage for IVF services at selected facilities, including Nairobi West Hospital and Fertility Point.
Ongoing Reforms in Teachers’ Medical Scheme
The statement confirms that SHA will continue contracting with vetted healthcare facilities after negotiations the completed, with providers required to offer walk-in, walk-out services under a zero-co-payment model.
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“Upon conclusion of negotiations, SHA shall continuously sign POMSF contracts with vetted facilities, which shall strictly offer walk‑in, walk‑out services with zero co‑payments,” the statement read.
According to the communiqué, structured dialogue mechanisms have been established, including a Joint KNUT National Executive Council meeting scheduled for 6–7 May 2026 and activation of county-level TSC committees within one week.
The parties also agreed that SHA will regularly publish and update the list of contracted healthcare facilities and implement cost-containment measures, such as audits, reviews, and network optimization.
The statement further notes continued engagement between SHA and KNUT leadership, as well as monthly consultations between the Cabinet Secretary for Health and healthcare providers to support the implementation of the scheme.
