The Kenya Medical Practitioners, Pharmacists and Dentists Union has given the national government seven days to resolve the nurses’ strike, warning that doctors will join the walkout if the standoff continues.
KMPDU Secretary General Dr Davji Bhimji Atellah said the strike has disrupted essential health services nationwide and pushed public hospitals into severe constraint. “Essential services have been disrupted. There is no better way to say that patients going to hospital who need nursing care cannot get it, and nursing care is key for any health service to be functional,” Atellah said.
“Today we have 40 days in our public hospitals across the country that are constrained. It is increasingly becoming unsafe when doctors, whom we know are in shortage in the country, are overburdened,” he added.
Atellah said hospitals now operate at the bare minimum, and the disruption has contributed to preventable complications and deaths, including among children. He urged the government to intervene rather than continue as though the health system were functioning normally. “The government of the day cannot continue to assume things are normal when a key component of the health system has been on strike for over 40 days,” he said.
What Nurses Are Demanding
The Kenya National Union of Nurses and Midwives called the strike on July 29, after negotiations over the 2017 Collective Bargaining Agreement failed to resolve the union’s demands. Six weeks later, the dispute remains open, and pressure has mounted on both levels of government to end it.
Union Secretary General Seth Panyako has rejected county claims that the agreement is unaffordable, calling it a binding document that governors cannot set aside. He has also questioned why counties have not confirmed thousands of Universal Health Coverage workers on permanent terms, despite receiving hundreds of billions of shillings in equitable share allocations for the current financial year.
The toll has grown alongside the standoff. The Kenya National Commission on Human Rights has called the dispute a public health and human rights crisis, citing reports of 79 deaths, among them maternal, newborn and perinatal cases, recorded between August 31 and September 2. The commission wants those figures verified independently.
How County Governments Have Responded
The Council of Governors has consistently urged nurses to return to work while talks continue. Council Chair Ahmed Abdullahi has argued that negotiations were already underway when the union called the strike, a point the union disputes. Some individual counties have moved to plug the gap directly. Kericho recruited 150 nurses on an emergency basis, with Governor Erick Mutai saying the hires would begin restoring services at county facilities.
Progress has been uneven elsewhere. By early September, a majority of counties had signed the CBA or received clearance to register it before the Employment and Labour Relations Court, according to the Kenya Union of Clinical Officers, while roughly a dozen counties remained holdouts. Nurses have accused the Council of Governors of stalling on implementation even where agreements exist on paper.
Where the National Government Stands
President William Ruto and the country’s governors met on September 7 under the National and County Governments Co-ordination Summit, with the nurses’ dispute among the central items on the agenda. The meeting followed a partial breakthrough on August 31, when the two levels of government agreed to move 7,789 Universal Health Coverage workers onto permanent and pensionable terms, backed by a Ksh8.6 billion allocation that includes statutory employer contributions.
The Ministry of Health says it continues to work with counties on health financing, workforce management and the settlement of outstanding healthcare claims, alongside measures to keep services running. Health workers’ unions argue that this falls short of the core issue: full implementation of the CBA itself, a document some nurses trace back to negotiations that predate the 2017 General Election.
The dispute also carries an echo of how the government has handled other labour disruptions this year. Health worker representatives have pointed to the swift resolution of an aviation workers’ strike in September as evidence that funding can move quickly when the government chooses to prioritise it, a comparison the nurses’ associations have used to argue their own demands have been deprioritised despite years on the table.
The Money Behind the Standoff
The dispute is unfolding against a health budget that grew substantially for the 2026/27 financial year. Treasury Cabinet Secretary John Mbadi proposed Ksh177.2 billion for the health sector, up from about Ksh138.1 billion in 2025/26, framing the increase as central to the government’s push for Universal Health Coverage. Parliament’s Budget and Appropriations Committee later approved Ksh175.5 billion for the sector.
The allocation includes Ksh19.1 billion for the Primary Healthcare Fund, Ksh4 billion for the Emergency, Chronic and Critical Illness Fund, and Ksh18.5 billion to sustain HIV, malaria and tuberculosis programmes. Referral hospitals received Ksh45.3 billion, the Kenya Medical Supplies Authority Ksh20.9 billion, and workforce development items included Ksh9.3 billion for medical interns, Ksh10.9 billion for the Kenya Medical Training College and Ksh3.2 billion for stipends and insurance covering Community Health Promoters.
None of that funding, however, resolves the CBA impasse directly, since the agreement’s costs fall largely on county payrolls rather than the national budget line for health. Analysts have also cautioned that a larger allocation on paper does not automatically translate into services on the ground, pointing to Kenya’s history of budget credibility gaps between what Parliament approves and what actually reaches facilities.
A Constitutional Right Under Strain
Kenya’s Constitution treats health care as more than a policy preference. Article 43 of the Bill of Rights guarantees every person the right to the highest attainable standard of health, covering reproductive health care, adequate housing and sanitation, freedom from hunger, clean water, social security and education. It further bars the denial of emergency medical treatment to anyone and requires the state to support people unable to provide for themselves.
Health care delivery, though, is a devolved function shared between two levels of government. The national government retains responsibility for health policy, financing, national referral hospitals, quality standards, health information systems, national public health laboratories and oversight of institutions such as the Kenya Medical Supplies Agency, the National Hospital Insurance Fund, the Kenya Medical Training College and the Kenya Medical Research Institute. Counties run the facilities where most Kenyans actually receive care.
The Kenya Health Policy 2014 to 2030 was meant to make that division work, setting out governance arrangements for efficient, accountable and equitable service delivery under devolution. In practice, the split of responsibility has proven difficult to manage, and the current strike has renewed debate over whether health service provision should remain devolved at all.
Public hospitals are often the only option for Kenyans who cannot afford private care, and every day the wards run short of nurses is a day that constitutional promise goes untested for people with nowhere else to turn. Resolving the CBA will settle a labour dispute. Building a system that does not lurch into crisis every few years will require the national government and counties to negotiate before nurses, doctors or any other cadre reach the point of walking out again.
