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Counties reject Duale’s plan to absorb 7,414 UHC medics
Tharaka Nithi County Governor and Council of Governors’ Health Committee Chairman Muthomi Njuki addressing journalists during a presser at the Wilson Airport in Nairobi on August 26, 2025.
All the 47 counties have unanimously rejected Health Cabinet Secretary Aden Duale's directive to absorb 7,414 Universal Health Coverage (UHC) medics on permanent and pensionable terms starting September 1, 2025.
Council of Governors (CoG) Health Committee Chairperson Muthomi Njuki announced the decision on Monday, citing four key reasons for the rejection: lack of consultation, absence of a verified list of legitimate medics, non-allocation of the agreed Sh7.7 billion, and unpaid gratuity owed to the health workers.
"The Ministry of Health and counties' partnership is supposed to be collaborative, not directive," Governor Njuki told journalists in Nairobi, criticising Mr Duale for making the announcement without consulting the CoG.
The dispute centres on the fate of 8,571 medics across 17 cadres who were contracted by the Ministry of Health in 2020 and deployed to Covid-19 frontlines across all counties. Despite promises of permanent employment and gratuity payments, the health workers have endured over 20 protests and five years of uncertainty.
A joint verification exercise between the Ministry of Health and the Council of Governors has exposed widespread fraud within the UHC programme, with the headcount revealing that some supposed health workers are actually plumbers, salon attendants, carpenters, and early childhood education teachers with no medical training whatsoever.
"While acknowledging the ongoing collaboration between the two levels of government in addressing the management of UHC staff, the Council of Governors wishes to clarify that it does not concur with the Ministry of Health's position expressed in the press statement," Governor Njuki stated.
The verification exercise, which concluded last week, sought to root out at least 3,000 ghost workers and left officials shocked at the extent of the fraud.
Governor Njuki estimates that Kenya has lost at least Sh9 billion over the past five years paying salaries to approximately 3,000 ghost workers across all counties. With UHC medics earning an average of Sh50,000 monthly, the 3,000 ghost workers cost the country Sh150 million each month, translating to Sh9 billion over the five-year period.
A Nation spot-check across 18 counties—Trans Nzoia, Bungoma, Narok, Bomet, Baringo, Elgeyo Marakwet, Kisii, Migori, Tana River, Garissa, Nairobi, Makueni, Samburu, Laikipia, Taita Taveta, Kwale, Murang'a, and Kirinyaga—found that only Baringo County could confidently verify 186 legitimate UHC medics out of 187 on their official records, with one medic failing to show up during verification.
Speaking to journalists in Eldoret earlier this month, CS Duale acknowledged the ghost worker problem and vowed to take action. "We got money through Parliament to make UHC medics permanent and pensionable, but vetting and verification is still ongoing because I want to pay only those who are working and present," he said.
The Health CS warned that those found earning salaries without proper qualifications would be forced to return all salaries earned over the past five years and promised to hand over cases to the Ethics and Anti-Corruption Commission.
"There are thousands of you who are ghost workers," Mr Duale told the medics. "So far, based on the figures that I have, I will hand over many of you to the Ethics and Anti-Corruption Commission because the number we are seeing of actual UHC medics compared to the number of people who were actually being paid for the last five years is just shocking."
The Council of Governors has outlined specific conditions that must be met before any absorption can take place. Governor Njuki emphasised that the Ministry of Health has not shared the list of verified UHC medics following the joint verification exercise.
"On the transfer of UHC staff, it was agreed that the Ministry of Health would allocate adequate resources as per the approved Salaries and Remuneration Commission salary scales before transferring the payroll to county governments," he explained.
The counties are also demanding that all gratuity payments owed to legitimate UHC medics be settled before any transition occurs.
"UHC staff currently engaged on contractual terms are entitled to gratuity. The Ministry of Health should therefore settle all gratuity payments for UHC staff before their transition to county governments," Governor Njuki stated.
Governor Njuki reminded CS Duale that the Constitution requires both levels of government to relate on the basis of consultation rather than directive, emphasising the need for collaborative decision-making.
"The Council of Governors recommends that the national government, through the Ministry of Health, allocates and channels the attendant resources to county governments to facilitate the absorption of UHC staff as per county human resource policies. Failure to do this will make the absorption of UHC staff unattainable," he warned.
CS Duale has emphasised that the government will only employ health workers who have graduated and completed proper training, not merely those who have finished their studies. His remarks come as part of broader efforts to end corruption in the Ministry of Health, particularly in nursing internship allocations.
The Health CS has challenged Kenya Medical Training Colleges to offer quality education that meets market demands, whilst promising a thorough vetting process to identify genuine healthcare professionals.
The Council of Governors reaffirmed its commitment to working collaboratively with the Ministry of Health to resolve all matters related to UHC staff, but insisted that proper procedures and constitutional requirements must be followed before any absorption takes place.
