Why nurses strike is far from over

The wrangling between the Council of Governors (CoG) and striking nurses is far from over, with the council declaring that the Collective Bargaining Agreement (CBA) at the centre of the dispute is financially unsustainable.

Yesterday, the CoG called on nurses to end their nationwide strike, maintaining that the industrial action is illegal.

CoG chairperson Ahmed Abdullahi said the CBA was signed under duress, had never been fully implemented and would be too costly for counties to sustain.

“We have tried to negotiate with nurses, and it is still ongoing. They called a strike, the court has said it is illegal, but they are still insisting,” said Abdullahi, during an Intergovernmental Budget and Economic Council (IBEC) meeting chaired by Deputy President Kithure Kindiki.

Abdullahi said the Council is seeking to resolve the dispute through negotiations, including engaging the SRC, which has also raised concerns over the sustainability of the CBA.

“We want to ask nurses to go back to work as we negotiate this matter. As the leadership of the Council, we offered a deal and we are hoping that if there is an agreement, we could go to SRC together,” added the CoG chairperson.

However, Abdullahi left individual governors and county public service boards to determine how to deal with nurses who have remained absent from work.

“The position we have taken as a Council is that every governor and Public Service Board deals with the issue of not responding to court orders in accordance with established HR procedures,” said the CoG chairperson.

But nurses, through their umbrella union, the Kenya National Union of Nurses and Midwives (KNUNM), accuse the Salaries and Remuneration Commiison (SRC) and CoG of dragging their feet on the signing of their CBA.

The CBA, according to KNUNM Secretary General Seth Panyako has remained unresolved for years.

In an interview with The Standard, the union official said it has pushed for a CBA since 2013, but their demands have been repeatedly ignored, a stalemate that continues to hurt patients across the country.

The official said the committee that had been appointed to negotiate the CBA did not forward it to CoG, or rather, they forwarded it and the council rejected it.

Panyako regretted that the rejection of nurses’ CBAs had become a trend over the years.

Previously, SRC is reported to have blamed the CoG for delaying the signing of nurses’ CBAs.

“We have negotiated about five CBAs. Even in 2017, there was one that was ready for signing, but SRC came in and refused to approve it. Now SRC says it has approved and CoG is the one not approving. Issues of nurses are not factored, so instead of getting solutions, they resort to threats and intimidation," said Panyako.

Abdullahi warned that disciplinary action could trigger another dispute, with dismissed nurses likely to seek reinstatement.

At the same time, the chairperson called for a closed-door engagement with SRC, arguing that counties were facing different payroll pressures while various health worker cadres continued to negotiate salary increases through their unions.

The CoG chair added that counties needed a broader discussion with SRC on the financial implications of the agreements.

In a quick rejoinder, Panyako said CoG is free to fire and hire nurses as it wished, but maintained that striking nurses would only return to work once their grievances were resolved.

As the standoff deepens, patients across the country continue to bear the brunt of disrupted health services, with nurses remaining away from their stations despite repeated calls to call off the strike.

Amid the dispute, Deputy President Kindiki directed the Ministry of Health, CoG and nurses unions  to immediately convene and urgently resolve the stalemate.

Kindiki acknowledged the nurses strike had paralysed healthcare services across the country.

“I am aware KNUNM is on strike. This industrial action has affected the smooth delivery of health services across the country.  I wish to encourage the CoG, in consultation with SRC, to conclude on the outstanding issues as soon as possible to facilitate resumption of services,” said Kithure.

The nurses’ strike is unfolding alongside another dispute over the financing and payroll management of Universal Health Coverage (UHC) staff, further piling pressure on county health systems.

Yesterday, Health Cabinet Secretary (CS) Aden Duale revealed that UHC staff would face a September pay crisis as counties resist payroll integration model.

Duale warned that the Ministry of Health has no money to pay them unless counties take them onto their payrolls or the funds are transferred to the ministry.

The Ministry, according to Duale had written a letter to the Speaker of the National Assembly, Moses Wetangula, and copied to the Controller of Budget, and CRA and the National Treasury, to have money moved from Conditional Integrated Grant Allocation (CIGA),  back to Disbursement of Revenue Allocation (DORA) but there was resistance from 12 counties.

Failure to have the 12 counties agree on resource allocation according to the CS is frustrating efforts to establish a sustainable payroll mechanism for the 7,786 UHC workers.

“It is good to be honest, even with the Council, about 12 counties have refused the direction,” said Duale.

“In September, there shall be no money to pay the people unless the money put in the conditional grant is transferred to the Ministry of Health, and also to Medical Services,” he added

The standoff centres on Sh8.6 billion allocated to facilitate the transition of UHC workers, including statutory employer contributions.

Initially, the Ministry of Health had asked the National Treasury to reclassify the money from the CIGA, under additional county allocations, to the DORA so that it could facilitate payment of the workers.

However, Treasury CS John Mbadi warned that the reclassification could delay disbursement of funds needed to pay the workers.

Instead, the National Treasury proposed that the money remain under CIGA for the 2026/27 financial year and be moved to DORA in the next financial year.

Duale said the government was now racing against time to resolve the matter before the September payroll, to avoid a health crisis.

The UHC workers were recruited by the Ministry of Health in 2020 in collaboration with the Public Service Commission

Under the contract, certificate holders were receiving monthly stipends of Sh40,000, and Sh50,000 for diploma holders.

Their remuneration was later aligned with Salaries and Remuneration Commission (SRC) scales.

In September 2025, President William Ruto directed to have the employees transitioned to permanent and pensionable terms.

The transition was expected to take effect on July 1, 2026, with counties expected to absorb the workers.

A multi-agency committee was established in June to oversee the process, followed by an attempt by the Ministry of Health to transfer the workers from the national payroll to county payrolls.

But the transfer failed after the migrated payroll was not received for integration into county systems.

Duale said the CoG subsequently resisted integrating the workers into county payrolls, arguing that the allocated funds should instead be channelled through DORA.

To prevent a disruption of salaries and possible strike action, the Ministry of Health reversed the payroll transfer and retained the workers on its payroll, processing their salaries for July and August.

However, the CS warned that the arrangement cannot continue without additional funding.

“We shall not be in a position to pay September because we do not have the resources,” he said.

According to the CS, the government must agree on both the disbursement of the Sh8.6 billion and the integration of the workers into county payrolls to avert another health sector crisis.

In defence, Abdullahi said the UHC payroll dispute was largely caused by a mismatch between the workers’ permanent and pensionable terms and the conditional grant mechanism through which Treasury funding was provided.

According to Abdullahi said the recruitment of UHC staff during an emergency period had also not been equitable across counties.

“When the money is put into DORA, there shall be counties that gain and those that lose, because recruitment itself was not equitable and aligned to DORA,” said the CoG chairperson. “This has pitted governors against each other and caused misunderstanding between ourselves and the ministry.”

The Council, he said, wanted to continue with the conditional grant arrangement, but raised concerns over the continued management of the payroll from the national level.

Abdullahi argued that this had created supervision challenges for counties and could contribute to absenteeism among staff who know their salaries are controlled elsewhere.

After a heated closed-door meeting, it was agreed ro have UHC staff confirmed on permanent and pensionable terms, with their pay channelled appropriately.

Under the agreement, the cost of employing the health workers will be factored into CRA revenue-sharing formula for the 2027/28 financial year to ensure counties do not lose their equitable share after absorbing the workers.

The Council also resolved that the financing and payment of UHC staff for the 2026/27 financial year will be provided through the County Governments Additional Allocations (CGAA).

Salaries already paid by the  Ministry of Health for July and August will be accounted for under the CGAA and reimbursed to the Ministry from September 1.

Additionally, the Ministry of Public Service, Human Capital Development and Special Programmes will facilitate the transfer of payrolls for eligible UHC workers to their respective counties.

County Public Service Boards will then undertake the formal absorption of the workers, with the Public Service Commission expected.