Doctors issue 14-day strike ultimatum as government fails to pay agreed salaries
Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) Secretary-General Davji Atellah during a press conference in Nairobi on April 26, 2025.
A health crisis looms after doctors issued a stern 14-day ultimatum to the government, threatening nationwide industrial action over the failure to implement agreed salary adjustments and clear outstanding arrears.
The Kenya Medical Practitioners, Pharmacists and Dentists' Union (KMPDU) delivered the warning on August 4, 2025, giving the government exactly two weeks to resolve all outstanding salary issues or face a crippling strike that would effectively shut down medical services across the country.
In a strongly-worded letter addressed to Chief of Staff Felix Koskei, Cabinet secretaries for Health, Treasury, Public Service and Labour, as well as all county governors, the union's message was unequivocal: honour your commitments or face the consequences.
The dispute centres on agreements that should have been implemented years ago. According to KMPDU Secretary-General Davji Bhimji Atellah, the outstanding issues stem from the Collective Bargaining Agreement (CBA) for 2017-2021 and the Return-to-Work Formula (RTWF) executed on May 8, 2024, and signed on December 19, 2024.
Under these agreements, doctors were promised salary adjustments and payment of arrears spread across different financial years, to be implemented in phases. However, the implementation has been plagued by delays, with healthcare workers pointing to bureaucratic inefficiencies and a lack of political will to honour the agreements.
"Despite these agreements, healthcare workers continue to experience significant delays in receiving their adjusted salaries and accumulated arrears," Dr Atellah said, emphasising that these are not new demands but rather the implementation of previously agreed terms that should have been processed months ago.
The union argues that healthcare workers feel betrayed by a system that promised improvements but has failed to deliver on its commitments, despite having signed formal agreements and court orders mandating compliance.
Documents obtained by Nation reveal a frustrating pattern of requests, approvals and subsequent delays that have left healthcare workers financially strained.
The saga began in February this year when the Council of Governors wrote to then Principal Secretary for Medical Services Harry Kimtai, Principal Secretary for Public Health and Professional Standards Mary Muthoni, and the National Treasury, requesting that funds be factored into county allocations to allow salary adjustments as agreed.
"After the letter, the Council of Governors then proceeded to have the money allocated in the County Allocation Act, and then they wrote requesting the National Treasury to disburse the money for them to pay the doctors. The money is yet to be released, yet the doctors were expecting this money by June in their salaries," Dr Atellah explained.
The salary adjustment should have been implemented in 2017, but was delayed until 2024 during the nationwide strike. It was agreed that the national government would pay the arrears in two instalments of Sh1.75 billion each.
The first instalment was paid in December and January, but the second instalment due in June remains unpaid. Additionally, salary adjustment arrears of Sh1.75 billion, which were supposed to be paid by counties in June, remain outstanding.
The National Treasury, through Principal Secretary Chris Kiptoo, acknowledged the delays in a letter dated May 26, 2025. Dr Kiptoo confirmed that Parliament had taken longer than expected to approve the County Government Additional Allocation Act 2025, resulting in no additional allocations being disbursed to counties in the 2024/25 financial year.
The Treasury had prepared a disbursement schedule as required under the Public Finance Management Act 2012, and funds previously reduced in Supplementary Budget II would be reinstated and regularised in Supplementary Budget III. However, the money was never released.
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On June 11, 2025, Dr Ouma Oluga, Principal Secretary for Medical Services, wrote to Treasury requesting the transfer of Sh1.75 billion in salary arrears for county government health workers, highlighting the County Government Additional Allocation Act 2025, which had specifically allocated these funds.
This was followed by a July 4, 2025, letter from Council of Governors Chief Executive Officer Mary Mwiti to the State Department for Public Service and Human Capital Development, requesting a new IPPD (Integrated Payroll and Personnel Database) code for adjusted doctors' basic salaries as revised in the 2017 CBA.
On July 9, 2025, Principal Secretary for Public Health and Professional Standards Mary Muthoni Muriuki wrote to Treasury Principal Secretary Dr Chris Kiptoo, requesting the disbursement of Sh1.75 billion for basic salary arrears, referencing the Return-to-Work Formula and emphasising the urgent need for intervention to prevent a nationwide strike.
Dr Atellah expressed growing concern about the fate of the allocated funds, questioning whether they might be diverted to other uses.
"We fear that the money for the arrears, which the government had promised to pay, is being eaten somewhere; somebody may be using it. Why would Parliament pass that the arrears be paid, then it is not given to doctors?" he questioned.
The union leader revealed a troubling reality about doctors' salaries: "The counties have the money for salary adjustment, but they cannot unless Public Service adjusts it in the payroll. This is yet to be done and we are waiting for it to be effected. Doctors have not received any salary adjustment since 2011."
He added: "Counties are claiming they have funds that only need approval for salary adjustments. If these adjustments are not made, we will revert to our previous situation. Our money is being mismanaged; if salaries are not adjusted, counties will lose out on these funds. If the Treasury fails to release the money, it will be redirected to other uses. This is why we are frustrated."
The union points to the County Government Additional Allocation Act of 2025 and allocations under Supplementary Budget III as evidence that the government has the resources but lacks the will to implement the agreements.
