SHA declined to enroll over 360,000 teachers for health coverage – TSC CEO reveals
Social Health Authority (SHA) declined to enroll over 360,000 teachers due to a lack of nationwide infrastructure.
Social Health Authority (SHA) declined to enroll over 360,000 teachers due to a lack of nationwide infrastructure.
According to Teachers Service Commission (TSC) CEO Nancy Macharia, their efforts to onboard teachers into SHA failed after being informed that the insurer lacked sufficient structures across the country to cater to the teachers.
Speaking before the National Assembly Education Committee, Macharia told MPs that the Commission has always wished to enrol teachers into a public insurance scheme, but this 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.
“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 enrol our teachers, but even then, they were not ready to take them on this year,” she told the committee.
The meeting came in response to numerous complaints from teachers across the country, who continue to suffer due to a lack of medical attention, despite the Ksh.20 billion contract that TSC signed with Minet to provide medical insurance for educators.
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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.
Luanda MP Dick Maungu called for teachers to be grouped into clusters based on job group or region to fast-track the approval process at health facilities, arguing that the current centralized mechanism is inefficient.
“With Bliss Health Care being the master capitator and considering the large number of teachers, it becomes difficult for them to handle approvals in time — and that’s where the delays come in. Why is it not possible cluster teachers to narrow it down? Currently, the system is overwhelmed,” Maungu remarked.
Macharia, however, cited inadequate funding as a major barrier to providing comprehensive medical insurance, and urged the committee to allocate more resources.
“If our teachers were to get the best medical services, they need to be fully insured. But we are unable to do that because of budgetary constraints. We also need timely disbursements to the consortium, because most times we delay,” she said.
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