President Ruto, governors race to end health strike as deaths fears grow

President William Ruto is set to seek a solution to the worsening health workers’ strike, as maternal health experts raise concern over a feared surge in the number of women and children dying from preventable complications.

President Ruto was expected to hold a meeting with governors on Monday, but the meeting did not materialise.

The President is now expected to meet governors and the Council of Governors (CoG) on Monday, in a bid to find a lasting solution to the deadlock that continues to paralyse health services.

Ruto committed last week during the Health Summit, promising to find a solution to the strike within a week.

At the summit, he said he was in talks with governors to address the issue of staff employed under Universal Health Coverage (UHC).

If the matter is not resolved, he said the employees would be placed on permanent and pensionable terms under the national government.

But the Kenya Union of Clinical Officers (KUCO) has said the move to address the plight of UHC staff alone will not resolve the broader challenges facing the striking workforce.

“The President was categorical; his meeting is about UHC employees, and not issues affecting the striking workforce,” said KUCO Secretary General George Gibore.

UHC staff, according to Gibore, are only about 8,000.

The strike has affected key cadres, including nurses and midwives, clinical officers, laboratory technicians, public health officers and pharmaceutical officers, with patients bearing the consequences.

The workers are demanding the signing and implementation of collective bargaining agreements (CBAs), promotions and improved salaries, among other demands.

In some areas, health facilities have been left operating with inadequate staff, while patients face postponed procedures, shortages of medicines and medical commodities, and delays in accessing essential services.

Gibore said UHC and Global Fund staff have already been issued with permanent and pensionable letters.

However, he said counties have remained reluctant to actualise the terms of employment, despite approval by the national government and the Ministry of Health.

The union official proposed the adoption of a system that is already working to address the challenges in human resource management.

“The biggest challenge is the fragmentation approach in the management of the health sector. This was proven during Covid-19,” said Gibore.

“When you mention UHC staff and Global Fund staff, they already have permanent and pensionable letters, but all those under counties are struggling. Every time they raise queries, some issues are not based anywhere. For example, even if money is provided, governors want it placed under equitable sharing, yet money has been provided under conditional grants,” added Gibore.

Clinical officers, for example, are demanding the implementation of CBAs and the signing of pending agreements.

At least 12 counties have yet to sign the clinical officers’ CBAs, despite negotiations spanning years.

The counties cited include Kitui, Nyandarua, Garissa, Mandera, Lamu, Busia and Kakamega.

Gibore said the failure to implement CBAs and career progression guidelines had fuelled repeated industrial action.

The counties were expected to sign the CBAs on February 2, 2026, a deadline that was later extended to February 16, 2026, but the documents are yet to be signed.

Initially, the documents were to be signed and taken to the Salaries and Remuneration Commission (SRC) before being presented to the court to enable their implementation.

The union is now proposing a centralised structure for managing health workers to reduce county-by-county disputes.

“If one person was to sign the CBA, the decision is made for everyone and avoids push and pull. This would have avoided friction, and we should have all been at work,” observed Gibore.

Two weeks ago, CoG Chief Executive Officer Mary Mwiti promised to have the strike resolved, even before the Health Summit was held.

However, Mwiti told journalists during a media town hall meeting that the strike had not affected all counties.

But reporting by The Standard has revealed significant disruption of health services in several parts of the country.

Doctors, although not on strike, have also warned of a paralysed healthcare system following the prolonged industrial action.

Gibore observed that the current stand-off has also highlighted the uneven manner in which counties manage their health workforce.

For instance, some counties have struggled to recruit and promote health workers, while others have expanded their workforce and invested in health facilities.

“Recurring strikes are a symptom of a system in which workers have to negotiate separately with individual counties,” said Gibore.

Meanwhile, maternal health experts have warned that the number of maternal and child deaths could rise as the health workers’ strike continues.

In Kenya, at least 15 women die each day from birth-related complications, with postpartum haemorrhage (PPH), or excessive bleeding, being a major contributor.

According to Prof Moses Maridadi Obimbo, End PPH Initiative Project Lead, the strike has left pregnant women due for delivery vulnerable.

“We are scared about the strike because services are paralysed. It is a concern,” said Prof Obimbo.

“It is very sad and concerning. We are likely to lose gains on maternal and child health,” he added.

Many health cadres are on strike, crippling the provision of essential services, including maternal healthcare.

Striking cadres include clinical officers, nurses, laboratory technicians and public health officers, among others.

Some maternity units in public health facilities have been forced to scale down services, with women seeking deliveries in private and faith-based facilities that are struggling with high patient volumes and limited capacity.

Kenya loses a high number of women during childbirth, largely due to three major causes, namely PPH, sepsis and obstetric complications.

Hotspot counties for PPH, according to Ministry of Health data, include Homa Bay, Machakos, Murang’a, West Pokot, Migori, Garissa, Tana River, Turkana, Elgeyo-Marakwet, Siaya, Wajir, Kilifi and Nairobi.

Prof Julius Ogeng’o, a professor of human anatomy at the University of Nairobi and End PPH co-lead, said informal settlements in Nairobi are among the most affected by PPH.

“Nairobi has low cases of PPH, but informal settlements record more largely due to poor infrastructure and limited access to essential health amenities,” said the researcher.

The urban poor living in informal settlements bear a disproportionate burden of PPH, he added.

“Lack of water, hygiene and sanitation contributes to negative outcomes, which contribute to more cases of sepsis (infections) and deaths,” said Prof Ogeng’o.

The researcher further called on Kenyans to volunteer to donate blood to save mothers during childbirth.

“Pregnant women should get blood at the bedside while seeking deliveries, so that they can be transfused instantly when needed, saving lives,” he said.

Unfortunately, Kenya has faced a shortage of blood, forcing mothers to wait for blood even during emergencies, leading to preventable deaths.

Kenya requires at least 500,000 pints of blood annually to save lives, but only about 400,000 are collected.

To avert deaths caused by PPH, the End PPH Foundation has launched the Roaming Blood Community Initiative to mobilise blood donations for mothers during delivery.

On her part, UNICEF Kenya Health Specialist Dr Laura Oyiengo said that while PPH remains a leading cause of maternal deaths in Kenya and globally, attention must also be paid to other complications that account for the remaining maternal deaths.

“PPH is the highest killer of mothers in Kenya and globally. At least 50 per cent of deaths,” said Dr Oyiengo.

Oyiengo said there is a need to equip facilities with maternal commodities, and train healthcare providers for quality services.

Delays, she said, also trigger preventable maternal deaths.

“Women should get to hospitals on time, while seeking delivery, and in hospital, there should be no delays in provision of care, to save lives,” she said.