COG, clinical officers seal CBA after eight-year standoff

After eight years of protracted negotiations, repeated nationwide strikes and prolonged disruptions of public health services, the Council of Governors (CoG) and the Kenya Union of Clinical Officers (KUCO) have finally signed a Collective Bargaining Agreement (CBA), bringing to an end one of the longest-running labour disputes in Kenya’s devolved health sector. 

The agreement, signed in Nairobi on Monday, marks a major turning point for clinical officers, who form the backbone of healthcare delivery in public hospitals and health centres across the 47 counties.

The stalemate has in the past led to frequent industrial action, leaving millions of Kenyans without access to essential medical services.

Present at the signing ceremony were county secretaries, county attorneys, chairpersons of County Public Service Boards (CPSBs), County Executive Committee Members (CECs) for Health, chief officers, and senior union officials, underscoring the high political and administrative stakes surrounding the deal.

“This has been a long and difficult journey,” said Muthomi Njuki, Vice Chairperson of CoG. “The governors gave full mandate for these negotiations because the dispute has lingered for too long, hurting both healthcare workers and the public.”

The breakthrough follows the signing of a return-to-work formula earlier in the week, which saw clinical officers suspend a nationwide strike that had paralysed services in public facilities. Under the agreement, all KUCO members are required to resume duty within 24 hours of the signing.

KUCO Secretary General George Gibore confirmed that clinicians had been formally instructed to return to work immediately.

“The strike has been suspended, and our members have been directed to resume duty not later than 24 hours after the signing of this agreement,” said Gibore. “This decision is in the interest of the country and the patients we serve.”

Among the key issues addressed in the CBA is the enhancement of the risk allowance for clinical officers from Sh3,000 to Sh5,000, following approval by the Salaries and Remuneration Commission (SRC) in December 2024.

The agreement also provides for the phased implementation of the third cycle of SRC salary reviews, which had stalled due to budgetary constraints following cuts to county allocations.

However, the signing did not come without concerns. Some County Public Service Boards raised questions about procedure, consultation and implementation, citing constitutional provisions that mandate CPSBs to manage county human resource functions.

Dr Cecilia Ngetich, the national chairperson of the County Public Service Board Consultative Forum, cautioned that while the boards support improved terms for health workers, due process must be followed to avoid legal challenges.

“We are not against CBAs or improving welfare,” she said. “But we must ensure that the process respects the constitutional mandate of County Public Service Boards and that governors give explicit financial concurrence, especially where salaries are being increased.”

In response, CoG officials assured counties that the negotiations were centrally coordinated to promote harmonisation across the devolved system and that all key stakeholders, including county attorneys, CPSBs and health executives, were represented in the negotiating teams.

“The centralisation was deliberate,” Njuki said. “If each county negotiated independently, we would end up with disharmony and inequity across the civil service. This agreement is county-specific, but harmonised.”

During the ceremony, three counties, Nakuru, Nandi and Garissa, symbolically signed the CBA, with assurances that documents for all 47 counties were ready and would be executed as counties complete internal processes.

Some counties noted that implementation would depend on fiscal capacity, with the effective financial date set for July 2025 to allow for budgeting.

“We will go back to our counties and form implementation teams,” said Embu County Secretary Emmy Ruria, who is also vice chair of the County Secretaries Caucus. “Different counties face different fiscal realities, and this must be acknowledged.”

In a statement, KUCO leadership described the CBA as a historic milestone but warned that without broader structural reforms, industrial unrest in the health sector could persist.

“This eight-year journey has exposed the destructive impact of fragmented human resource management in the devolved health system,” said Gibore. “We believe sustainable peace can only be achieved through a coordinated, central framework for managing human resources for health.”

The union proposed the establishment of a national commission or a strengthened mechanism under the Council of Governors to ensure uniformity, fairness and timely dispute resolution across counties.

“We envision one nation, one health service,” the union said, calling for a constitutional audit of the devolved health function to address inefficiencies and governance gaps.

Clinical officers say the dispute dates back to 2017, following a strike that produced career progression guidelines and a draft CBA that were never fully implemented. Subsequent court cases, broken timelines and unfulfilled promises eroded trust between workers and employers.

KUCO Chairperson Peterson Wachira said repeated strikes were driven by a pattern of commitments made during crises and abandoned once workers returned to duty.

“Trust collapsed because agreements were signed but never implemented,” he said.

Union leaders urged both sides to turn the page. “If we have hurt anyone in this process, we ask for forgiveness,” a union leader said. “But let us remember there is no socio-economic development without health, and no health system without motivated workers.”