Nurses strike enters fifth week as CBA implementation remains unresolved

Kenya National Union of Nurses and Midwives officials led by Seth Panyako during a media briefing on the ongoing strike by nurses over Collective Bargaining Agreement with County Governments on September 1,2026.[Benard Orwongo Standard]

Mbagathi Hospital is operating below full capacity as the  nurses’ strike enters its fifth week, with management relying on locum staff to keep essential services running.

Dr Erica Koima, Medical Superintendent at Mbagathi Hospital, said the facility had brought in qualified locum nurses  as a stopgap measure following the withdrawal of some nurses.

“We are not fully operational in terms of the human resource, but at least we are able to give services,” Dr Koima said.

She said the number of patients seeking care had dropped by more than half, with the hospital now attending to fewer than 500 patients a day compared with more than 1,000 before the strike.

Dr Koima attributed the decline partly to patients assuming that services at the hospital had been disrupted.

Some patients, however, said they were still experiencing delays.

Jennifer Kioko of Lang’ata, who accompanied her son to the hospital after he complained of stomach and joint pains, said they arrived at 8am but by 3.30pm had still not received treatment.

Kioko said services were slow and the number of patients was high, even as the nurses available continued attending to patients.

“Even though the available nurses are working, you should practise patience when you come here for treatment,” she said.

Another patient attendant, who requested anonymity, said her relative had been admitted at the facility since Monday and that they had been received well.

She said the admission process was fast and smooth, crediting the nurses available for doing their best to keep services running despite the strike.

However, she raised concerns over patients being asked to purchase medicines from outside the hospital, saying this added to the burden of seeking treatment.

The situation comes as the Kenya National Union of Nurses and Midwives (KNUNM) maintains that its members will not return to work until their Collective Bargaining Agreement (CBA) is implemented.

The union said on Tuesday that talks with the Council of Governors had yielded progress on two issues that had been part of the dispute; the employment of Universal Health Coverage (UHC) staff and career progression guidelines.

KNUNM Secretary General Seth Panyako said UHC nurses in some counties, including Mombasa, had started receiving permanent and pensionable (P&P) letters from Monday, with the process expected to be rolled out across all 47 counties this week.

The union has also agreed with governors on a roadmap for career progression guidelines.

Under the arrangement, union officials will join a committee with the Council of Governors to review guidelines developed by the Public Service Commission and work out how they can be adopted by individual counties.

“For now, we can say in relation to this dispute, it has been resolved,” Panyako said.

Despite the progress, the CBA remains the main sticking point.

“The main elephant in the house is the issue of the collective bargaining agreement,” Panyako said.

KNUNM National Chair Joseph Ngwasi said implementing the CBA would cost about Sh5.9 billion, dismissing claims that the agreement is financially unsustainable.

Ngwasi said the amount was achievable, arguing that the government had previously committed substantial resources to other agreements.

The union’s irreducible minimums include implementation of the CBA, risk allowance and a review of uniform allowance for nurses.

“Risk allowance, that is our bare minimum. Again, we earned a review of uniform allowance for the nurses,” Ngwasi said.

The union also rejected claims that the 2017 Return to Work Agreement, which forms the basis of its current CBA demands, was signed under duress.

Deputy Secretary General Maurice Opetu said the agreement was signed on November 2, 2017, following negotiations involving both the national and county governments.

“Nobody was under duress that time,” Opetu said, arguing that none of the officials who signed the agreement had subsequently claimed they were coerced.

He said nurses had worked for years without the agreement being fully implemented despite repeated attempts to resolve the matter.

The union is now planning to escalate pressure on the Salaries and Remuneration Commission (SRC), where nurses will camp on Thursday.

Panyako said the union would spend the entire day at the SRC offices as it pushes for implementation of the agreement.

“On Thursday, we will be camping at the SRC offices for the whole day,” he said.

The union has also called on President William Ruto to intervene, citing his earlier promise to personally arbitrate between the nurses and the Council of Governors.

For now, progress on UHC staff and career guidelines has failed to end the strike.

With implementation of the CBA still unresolved, KNUNM says nurses will remain out of public health facilities and continue piling pressure on the government and county authorities to implement the agreement.