Civil servants protest new SHA rules, say outpatient limited to Ksh2,500
By Kenneth Mwenda, April 15, 2026Civil servants have raised the alarm over changes to their medical cover under the Social Health Authority (SHA).
The Union of Kenyan Civil Servants protested on Wednesday, April 15, 2026, claiming the authority capped outpatient services at Ksh2,500 per visit.
Lawrence Ochieng, Secretary General of the Union of Kenyan Civil Servants, said the new limit leaves public officers with little real protection.
“SHA has limited the outpatient scheme to Ksh2,500, which basically means that we as civil servants are not insured because Ksh2,500 is merely a consultation fee,” he said.
“We are warning SHA that we will take legal action against them if they continue acting without consultation. We are surprised that SHA has not differentiated between the universal health coverage and our scheme.”
The union wants the full restoration of the previous medical benefits for public officers. It argues that the changes go against terms agreed earlier.
New tariffs spark dispute
The dispute follows SHA’s announcement on Monday, 13 April 2026. The authority rolled out new tariffs for the Public Officers Medical Scheme Fund (POMSF) after talks with Level 5 and Level 6 hospitals.
The authority said it carried out a market analysis and held negotiations with the hospitals. It plans to implement the new tariffs across all facilities within the next 21 days. The changes will cover service access, claims submission, how officials judge claims, and how they pay hospitals.
“The Authority shall conduct a market analysis during the first three (3) months of the commencement of the POMSF Scheme and following negotiations with healthcare facilities, provide final tariffs subject to approval by the SHA Board,” the statement read.
POMSF gives comprehensive cover to civil servants, teachers, members of the disciplined services, and their dependants. It includes inpatient, outpatient, and specialised services.
SHA said the updated tariffs reflect current market realities and the real costs that hospitals face. The aim is to create fair reimbursement rates. Hospitals that accepted the new terms will continue to treat POMSF patients according to the agreed benefit packages.
The authority has now started talks with Level 4 and Level 3 hospitals to extend the new structure.
Union officials insist the Ksh2,500 cap does not match the needs of civil servants. They say many outpatient visits cost far more than consultation alone, especially when tests or medicines are required. The limit, they argue, effectively removes meaningful insurance for day-to-day health needs.