Healthcare crisis as clinical officers begin nationwide strike

(Left) Kenya Union of Clinical Officers (KUCO) Secretary-General George Gibore accompanied by (KUCO) Assitant Secretary-General Austin Oduor when the union announced to their members not to report to work citing failured negotiations with the Council of Governors (CoG) and the Ministry of Health (MoH) over salary harmonization, comprehensive medical cover, inadequate recruitment, and the absorption of staff under the Universal Health Coverage (UHC) and Global Fund programs into permanent terms at Upper Hill Gardens, Third Ngong Avenue, Nairobi on February 17, 2025. [Standard, Kanyiri Wahito] The Kenyan healthcare system is once again on the verge of paralysis as clinical officers begin a nationwide strike. Under the Kenya Union of Clinical Officers (KUCO), healthcare workers have accused both the national and county governments of failing to honor their commitments, a situation that continues to hinder service delivery. KUCO Secretary General George Gibore has affirmed that the strike, which began yesterday, will persist until their grievances are addressed by both levels of government. Among the key issues raised is the failure to schedule negotiations for the next Collective Bargaining Agreement (CBA). Unlike doctors and nurses who already have a CBA, clinical officers do not have one, and their push to have one is frustrated by The National Treasury, which is required to sign, and therefore guarantee its actualisation. Unfortunately, the union regrets that Council of Governors (CoG) is not ready to have the CBA concluded and signed. "Governors through CoG have agreed to negotiate and find solutions to issues affecting clinical officers, but they want us to exclude CBA from the negotiation table. We feel this is not the right thing because it contains issues that continue to face clinical officers," said Gibore. In an interview with The Standard, Gibore said the union suspended the strike notice that has been scheduled last month after the Council of Governors and the Ministry of Health pleaded to address the issues. The arms requested 21 days to negotiate and find a solution, but nothing has been met. "CoG has written to the union requesting for more time, but they want us to exclude CBA, a move we feel is ill-motivated," said the union representative. A number of counties have also written to the union pleading saying they are ready for negotiation, among them Baringo, Nandi, Nairobi, Meru, and Murang'a, including Moi Teaching and Referral Hospital (MTRH). But even with hesitancy by CoG to have CBA, Gibore maintains that clinical officers will keep of hospitals until the CBA is negotiated and signed ready for actualization. "Finalisation of the CBA, that is yet to happen, the ministry has forwarded the document to Treasury where it is pending. We do not have a CBA, and never shared centrally. They ought to have been finalized because we feel the county should have out time for 21 days, they did not give a priority," said Gibore. The union is also demanding for placement of 800 clinical officers employed under Universal Health Coverage (UHC), under permanent and pensionable terms. The clinical officers were recruited alongside 9,000 other health workers during the Covid-19 pandemic to strengthen health services. Additionally, the union wants the national government to absorb some 200 clinical officers employed by Global Fund, whose support came to an end nine months ago. "It is worrying the clinical officers under Global Fund have not been paid for nine months, whereas those serving under UHC have not been put on a permanent basis despite numerous promises by the government," regretted Gibore. Other issues raised by the striking workforce include non-dissemination of the approved career guidelines for clinical officers to county governments, despite formal requests with the latest dated January 31, 2025. They have also complained about the non-implementation of resolutions from the January 14, 2025 meeting between the Ministry of Health and KUCO regarding contracting, impaneling of facilities, and payments of related benefits to licensed facilities and practitioners by the Clinical Officers Council through Social Health Authority (SHA). With this, clinical officers are not cleared to run hospitals, until they get approval by the Kenya Medical Practitioners and Dentists Council (KMPDC). The limitation of practice is even reported despite the professionals being accredited by the Clinical Officers Council. They also raise an issue with lack of commitment towards the promotion and re-designation of clinical officers in accordance with career guidelines by most counties. Gibore further regretted that despite offering health services to patients, some clinical officers in respective counties struggle to access care due to lack of a comprehensive health cover. Among counties that have failed to provide the employees with medical coverage include Embu, Makuen, Marsabit, Isiolo, Garissa, Moyale, Mandera, Lamu, Uasin Gishu, Vihiga, and Baringo. The clinical officers strike comes even as the Wajir Governor also the chairperson of the Council of Governors Ahmed Abdullahi acknowledged the need to address labour issue affecting health workers across the country. In a health summit held in Nairobi on Monday, Abdullahi said addressing the issues affecting the workers will guarantee a stable and motivate workforce. "Healthcare workers unrest is a perennial challenge and undissolved issue, that is labour concern," said the Governor. He added, "Return to work formula delays, and incomplete absorption of UHC staff into permanent and pensionable has resulted into unrest that affects service delivery and continuity that should be addressed to ensure a stable and motivated workforce".

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