The Teachers Service Commission (TSC) has introduced fertility care services for teachers under the Social Health Authority (SHA) Mwalimu Comprehensive Cover.
In a notice on April 30, TSC confirmed that In‑Vitro Fertilization (IVF) services have been formally activated under the health scheme and are now available at the Nairobi West Hospital.
The services, according to the Commission, took effect on 24 April 2026, following SHA approval and accreditation of the facility.
“This benefit is now accessible at Nairobi West Hospital, a contracted and accredited healthcare provider under the scheme, with effect from 24 April 2026,” read part of the notice.
TSC Eligibility Criteria for Fertility Care Services
According to TSC, the introduction of fertility care recognizes infertility as a medically established condition with physical, emotional, and social effects.
The commission said the benefit is intended to support affected members and their families by providing safe and regulated access to specialized treatment within the existing health cover.
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Access to fertility services is limited to beneficiaries enrolled in the SHA Mwalimu Comprehensive Cover, also referred to as SHA POMSF.
Eligible applicants include the main member and their legally registered spouse, and to qualify, applicants must provide medical proof that they have been unable to conceive after trying for one year without using contraception, or a doctor’s confirmation that they have a fertility problem.
Clinical Requirements for Accessing Treatment
Both primary and secondary infertility cases qualify for support under the scheme. However, for secondary infertility, couples must not have a living child at the time of treatment.
All applications must be accompanied by a documented clinical diagnosis and a written recommendation from a registered specialist.
The program sets clear treatment limits, and each beneficiary is eligible for a maximum of two IVF attempts over their lifetime.
In addition, the female partner must be aged 41 years or below at the commencement of the treatment cycle.
TSC noted that fertility care services will be provided within the existing inpatient benefit limit under the Mwalimu Comprehensive Cover. Covered services include standard IVF procedures and Frozen Embryo Transfer (FET) cycles, which are subject to the same overall benefit limit.
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Fertility Treatment Coverage and Compliance Requirements
In cases where a treatment cycle is canceled or does not result in pregnancy, such as due to poor ovarian response, failure to retrieve viable oocytes, unsuccessful fertilization, lack of viable embryos, or failed implantation, costs incurred up to that point will still be charged against the inpatient benefit.
According to TSC, treatment will continue until the hospital cover runs out or the person has used their two IVF attempts, whichever happens first.
All fertility treatment must follow national medical guidelines and must be approved by SHA before treatment begins.
Only services received at SHA‑contracted and accredited facilities will be eligible for reimbursement, with Nairobi West Hospital currently approved to offer the treatment.
“All fertility care services must strictly follow national clinical guidelines and SHA pre-authorization procedures. Only services provided at SHA‑contracted and accredited healthcare facilities will be eligible for reimbursement,” stated TSC.
TSC advised eligible members seeking fertility care to follow established referral and approval procedures before commencing treatment to ensure compliance with scheme requirements.
