Nairobi County workers are still facing challenges accessing medical services despite the county increasing its medical insurance expenditure to 2.5 billion shillings, raising questions about whether the higher cost has translated into better healthcare for employees.
The concerns emerged after Nairobi City County Workers Union branch secretary Calvince Okello appeared before the County Assembly’s Labour Committee, where he outlined complaints from members over access to hospitals, treatment limits and differences in medical benefits across job groups.
“Chair, complaints have increased not vanished.…Facility and accessibility has become an issue,” Okello told the committee.
The union said some workers were struggling to access facilities under the current cover provided by APA Insurance, despite an agreement that was expected to allow members to receive medical services without unnecessary restrictions.
According to Okello, some members have reported difficulties accessing certain hospitals, while others have been informed that their treatment is subject to financial limits that vary by day, week or month.
He also raised concerns that employees in different job groups were accessing different categories of hospitals, a situation he said was causing frustration among members.
Okello maintained that the agreement with the insurer was intended to provide services without the restrictions now being reported by workers.
“Chair, Because of various complains being raised by members, we thought we do request the county executive to be able to seek a private medical cover for our members,”
ALSO READ:One registrar for 13 sub-counties: Inside Bungoma’s civil registration crisis
Higher insurance costs, but complaints persist
The concerns have renewed questions about the county’s spending on employee medical insurance, particularly following successive changes in service providers.
Nairobi County previously had a medical insurance arrangement with Jubilee Insurance, reported to have cost 1.5 billion shillings, before moving to the Social Health Authority (SHA) in November 2025.
The county’s arrangement with SHA was valued at 1.4 billion shillings. However, the union terminated the arrangement in 2026 following complaints from members who said the cover was not adequately meeting their medical needs.
The county subsequently moved to APA Insurance in September 2026 under a reported 2.5 billion shillings arrangement.
Despite the change, workers continue to raise concerns about access to treatment and the range of services available to them.
The transition from one provider to another has therefore left questions about whether the county’s insurance arrangements are addressing employees needs and delivering value for public money.
MCAs question value for money
Members of the County Assembly’s Labour Committee questioned why workers were still experiencing difficulties accessing medical services despite the increase in the reported cost of insurance.
The committee, chaired by Kayole North MCA Paul Wachira, sought answers on why the successive changes in medical insurance providers had not resolved the concerns raised by county employees.
“Why didn’t you iron out the complains in SHA instead of moving to another medical scheme which is doing a disservice to its members and not giving value to the tax payers?,” Wachira asked.
The legislators also questioned the rationale behind spending more on the current arrangement when workers were still complaining about the services available to them.
The committee warned that it could push for the termination of the agreement between the county and APA Insurance if the cover failed to meet employees’ needs.
“The cost of APA is 2.5 billion, which means they are charging us more, how was this possible?” Mathare North ward MCA Oscar Lore asked.
The concerns place the county’s medical insurance arrangements under scrutiny, particularly over whether the benefits available to workers match the amount being spent.
Quality assurance committee set up
Okello said the union was addressing members complaints and had taken steps to monitor the implementation of the medical cover.
He told the committee that a quality assurance committee had been constituted the previous week to examine the day to day running of the insurance arrangement and identify solutions to the problems reported by members.
The committee is expected to assess the challenges affecting access to healthcare and help address concerns raised by employees.
ALSO READ:Taqwa SACCO members fear losing Sh387.5m as Jeevanjee housing project stalls for seven years
County executive expected to explain medical cover challenges
The County Assembly’s Labour Committee is scheduled to meet the county executive to discuss the concerns raised over the medical insurance arrangement.
The meeting is expected to provide an opportunity for the executive to explain the challenges affecting workers access to healthcare, the terms of the current insurance contract and the measures being taken to ensure employees receive the services they need.
The discussions could also clarify whether the county intends to retain the current arrangement with APA Insurance or consider further changes if the complaints remain unresolved.
The union represents approximately 9,800 members, while Nairobi County has about 18,000 workers, according to figures presented in the account of the committee proceedings.
With thousands of employees depending on the county’s medical insurance arrangements, the effectiveness of the cover remains an important issue for workers and taxpayers alike.
The key question is whether the new quality assurance measures will resolve the reported restrictions and improve access to treatment, or whether the county will have to reconsider its arrangement with the insurer.
Leave a Reply