SHA: Maternity Coverage – Comprehensive Care for Growing Families
Supporting Teachers Through Pregnancy and Childbirth
The TSC-POMSF scheme recognizes that welcoming a new child is one of life’s most significant events, and it provides comprehensive maternity coverage to ensure both mother and baby receive quality care without financial stress.
Who Qualifies for Maternity Benefits?
Critical Eligibility Note: Maternity benefits are available ONLY to:
- Principal members (the teacher)
- The legal spouse of the teacher
Not covered: Dependent children (even if they’re within the age range and enrolled in the scheme)
Maternity Benefit Amounts by Job Group
The scheme provides graduated maternity coverage:
Job Groups B5, C1, C2, C3, C4, C5:
- KSh 120,000 per pregnancy
Job Groups D1, D2:
- KSh 200,000 per pregnancy (66% increase)
Job Group D3, D4:
- KSh 250,000 per pregnancy
Job Group D5:
- KSh 300,000 per pregnancy (150% more than base level)
Comprehensive Antenatal Care
Routine Antenatal Check-ups: The scheme covers all recommended prenatal visits, including:
- First trimester screening and consultations
- Regular monitoring throughout pregnancy
- Ultrasound scans to monitor fetal development
- Laboratory tests (blood work, urine tests, gestational diabetes screening)
- Blood pressure monitoring
- Nutritional counseling
Delivery and Childbirth Coverage
Normal Delivery
- Full coverage for delivery fees
- Doctor’s or midwife’s fees
- Facility charges
- Immediate post-delivery care
Emergency Cesarean Section
- First C-section: Fully covered when medically necessary
- Subsequent elective C-sections: Also covered
- Normal delivery after C-section: Covered (VBAC – Vaginal Birth After Cesarean)
Delivery Room Accommodation
Special Benefit for Principal Members:
- Private room accommodation when available
- Applies to all expectant principal members and their spouses
- Provides privacy and comfort during and after delivery
- Subject to availability at the chosen facility
Postnatal Care
Mother’s Post-Delivery Care:
- Post-delivery check-ups
- Management of post-delivery complications
- Counseling on postpartum care and recovery
- Lactation support and breastfeeding guidance
Newborn Care:
- Immediate newborn assessment and care
- Monitoring in the first hours and days of life
Immunizations and Preventive Care
Routine Immunizations (KEPI): The scheme covers Kenya’s Expanded Programme on Immunization, including:
- BCG vaccine (at birth)
- Polio vaccines (multiple doses)
- DPT-HepB-Hib vaccine (Pentavalent)
- Pneumococcal vaccine
- Measles-Rubella vaccine
- All other vaccines in the national immunization schedule
Baby-Friendly Vaccines: Additional recommended vaccines beyond the basic KEPI schedule are also covered, ensuring comprehensive immunization for newborns.
Special Circumstances Coverage
Pre-maturity and Preterm Births
When babies are born prematurely:
- Special neonatal care is covered
- NICU (Neonatal Intensive Care Unit) charges included
- Extended hospitalization for premature infants
- Specialized feeding and medical support
Congenital Conditions
If a baby is born with congenital conditions:
- Immediate diagnosis and assessment covered
- Treatment and management within benefit limits
- Ongoing care integrated into the child’s dependent coverage
What’s NOT Covered
Important exclusions to note:
- Maternity cover for dependent children (even those aged 18-25)
- Elective procedures not medically necessary
- Private vaccines not on the recommended schedule (must be prescribed)
Planning Your Maternity Journey
Before Pregnancy
- Ensure you’re enrolled in the scheme
- Verify your nearest approved maternity facilities
- Understand your job group’s maternity allocation
During Pregnancy
- Register for antenatal care early (first trimester recommended)
- Attend all scheduled check-ups—they’re fully covered
- Use approved providers for continuity of care
Delivery Planning
- Confirm your chosen facility accepts the POMSF scheme
- Pre-register at the facility if possible
- Know the process for emergency situations
After Delivery
- Ensure your newborn is registered as a dependent
- Complete the KEPI vaccination schedule
- Attend postnatal check-ups
Real-World Example
Teacher in Job Group D3 expecting first child:
- Total maternity allocation: KSh 250,000
Typical expenses covered:
- Eight antenatal visits with ultrasounds: ~KSh 40,000
- Laboratory tests throughout pregnancy: ~KSh 15,000
- Normal delivery with 2-day hospital stay: ~KSh 80,000
- Private room upgrade: Included
- Postnatal check-ups: ~KSh 10,000
- Baby’s immunizations (first year): ~KSh 20,000
- Total: ~KSh 165,000
Remaining balance: KSh 85,000 available for any complications or additional needs
Emergency Maternity Care
If you experience complications requiring emergency intervention:
- Emergency cesarean sections are fully covered
- Transfer to higher-level facilities is covered under evacuation benefits
- Emergency care is accessible even outside your regular provider panel
In Post 6, we’ll examine dental and optical benefits—essential services often overlooked in medical coverage.