The reality of looming health crisis as CoG, Ministry trade blame

The Kenya National Union of Nurses and Midwives, through its Secretary General, Seth Panyako, during a media briefing on July 23, 2026.[Benard Orwongo Standard]

A spat between the County and the national government over the fate of Universal Health Coverage (UHC) is set to hurt service provision to Kenyans in medical facilities as the strike entered its second day.

While the Public Service Commission acted on a request by the Ministry of Health to move the staff to counties, the Council of Governors accused the ministry of sabotaging county governments by inciting the health workers to strike.

On Thursday, the fight between the two governments threatened to heighten the crisis in Kenya's public healthcare system, as the Council of Governors (CoG) directed county public service boards to ignore a Ministry of Health directive on the absorption of Universal Health Coverage (UHC) workers, even as nurses issued a seven-day strike notice over similar grievances.

The latest development comes as clinical officers, public health officers and other health workers under the Health Sector Caucus continue with a nationwide strike, raising fears of further disruption to healthcare services if nurses and midwives also down their tools on July 29.

The Kenya National Union of Nurses and Midwives (KNUNM) said it had issued the strike notice after years of unsuccessful negotiations with the government over unresolved labour issues.

"We have remained patient for far too long. We remain open to meaningful dialogue, but we will no longer accept empty political rhetoric," said KNUNM Secretary General Seth Panyako.

Panyako said the union is demanding the implementation of the 2025–2029 Collective Bargaining Agreement (CBA), the 2017 Return-to-Work Agreement, the implementation of Career Guidelines for Nursing Personnel, reinstatement of 46 nurses dismissed in Kisii County and the confirmation of UHC workers to permanent and pensionable terms.

He warned that failure to address the grievances would leave the country staring at a healthcare crisis.

"A demotivated, unprotected and underpaid nursing workforce is a direct threat to safe patient care," he said.

Like the Health Sector Caucus, Panyako said if county governments are unable to meet their obligations to health workers, the national government should take back the management of the health workforce.

However, the Council of Governors maintains that county governments cannot absorb the workers under the current arrangement.

Speaking during the Annual General Meeting of the County Pension Fund in Isiolo, CoG Chairperson Ahmed Abdullahi said the Principal Secretaries for Health and Public Service had no legal mandate to direct county public service boards to place UHC workers on permanent and pensionable terms.

"The Principal Secretaries cannot write to the county public service boards giving instructions that have no basis in law. You should disregard those instructions," Abdullahi said.

He argued that the Sh8.9 billion allocated by the National Treasury would only cater for the workers for one financial year and challenged the national government to provide a long-term funding model.

"The Ministry of Health is inciting the workers to strike. That is sabotaging county governments, yet it has not done its part of the agreement," he said.

Abdullahi called on the national government to amend the law, if necessary, to provide counties with sustainable funding for UHC workers through the equitable share.

His remarks come a day after Health Cabinet Secretary Aden Duale insisted that the national government had already fulfilled its obligations and that it was now up to county governments to absorb the workers.

"The strike issue should be addressed by the right people because I have done my part. It is now upon the county governments to do their part," said Duale.

The dispute over UHC workers has emerged as the common thread uniting different health unions, with clinical officers, public health officers, nurses and other cadres all demanding their confirmation to permanent and pensionable terms alongside the implementation of previous labour agreements.

If unresolved, the planned nurses' strike is expected to deepen the ongoing disruption in public hospitals, escalating the standoff between health workers, the national government and county governments over the future of Kenya's public healthcare system.