Duale has failed us: UHC medics protest broken absorption promise
For six years, they stood on the frontlines. They answered the call when Covid-19 swept across Kenya, deployed to all 47 counties with nothing but promises. Now, 7,414 Universal Health Coverage (UHC) medics have had enough.
On Tuesday, 17 cadres of health workers downed their tools in a nationwide protest, demanding that Health Cabinet Secretary Aden Duale honours commitments that have been deferred and denied for too long.
"To support health workforce sustainability, the Ministry has allocated Sh6.2 billion for UHC contract health workers. This is a government that acts, not just talks," CS Duale declared in June 2025. Three months later, the investment remains a mirage.
The medics were contracted by the Ministry of Health in 2020 and deployed to Covid-19 frontlines with promises of permanent and pensionable terms and gratuity—promises that have proven to be hot air.
In August, CS Duale announced that the medics, who had been on strike for seven months, would be absorbed on permanent and pensionable terms starting September 1, 2025. September came and went. The absorption did not happen.
"Out of the 7,629 UHC staff verified, 215 failed to present themselves. These individuals have been identified as either ghost workers or unqualified health professionals," Duale stated, adding that the remaining 7,414 eligible staff would be placed in two categories: those in active service and those facing disciplinary cases.
Medical Services Principal Secretary Ouma Oluga later clarified the confusion. "The CS statement relates to transition from a temporary contract to permanent and pensionable. My letter to the Council of Governors relates to the status of those on duty versus those not on duty for cleansing the payroll," Dr Oluga told Nation.
Three months later, the medics remain in contractual limbo.
"Previously, we were confused as to who our employer is because our contracts were issued by the 47 counties but our salaries came from the Ministry of Health," UHC medics' representative Lynn Wanjiku told Nation. "This month, the Labour Relations Court ruled that we are employees of the national government—the Health ministry."
The legal clarity has not translated into employment security.
"In August, CS Duale said that effective September 1, we will be absorbed, yet when our payslips came back, they had just harmonised our salaries but retained us on the same contract," Ms Kihara said.
"We cannot be more patient. It has been six years of pushing for our rights. If the government does not transition us now, the first group will go home in April after their contract expires, while the second will go home in November 2025."
She called out the counties victimising members for participating in strikes.
"Counties including Nyeri, Kiambu and Kirinyaga have dismissed our members. The Labour Relations Court ruled that we are entitled to 31 percent of our gratuity. The Council of Governors, under outgoing Health Committee Chair Muthomi Njuki, said counties cannot employ us until we are paid our gratuity. We ask President Ruto and CS Duale to transition us immediately."
Reduced salaries
Another grievance involves community oral health officers. When the ministry harmonised salaries, this cadre received Sh15,000 less than before, even as other cadres saw increases.
"They are taking less than Sh30,000 home, which is unfair after serving for six years. They wrote to the ministry. The ministry said they do not deserve allowances. Don't they work in health facilities?" Ms Kihara asked.
Patrick Sitati, another UHC national representative, said the medics will stage protests outside the Ministry of Health every Tuesday for the next month. If CS Duale does not address their grievances, they will appeal to the entire medical fraternity to down their tools in solidarity.
"If the ministry does not convert our employment terms, we are not afraid of a full-blown nationwide strike," Mr Sitati said. "If they do not want to do so, let them sort out our gratuity in full and then let us go home for good once our terms expire."
On August 31, governors convened an emergency meeting to discuss the stalemate. Nation learnt they were mulling termination of contracts if CS Duale pushed the payroll to counties without the Sh7.7 billion counties need for absorption.
"The relationship between the Ministry of Health and counties is supposed to be collaborative, not directive," Governor Muthomi Njuki told CS Duale. "The Council of Governors does not concur with the ministry's position expressed in the press statement. It contradicts the previously agreed position between the national and county governments."
Governor Njuki highlighted that the ministry has not allocated the agreed Sh7.7 billion for absorption and reminded CS Duale to ensure gratuity is fully paid before absorption takes effect.
"It was agreed that the ministry would allocate adequate resources as per the approved Salaries and Remuneration Commission salary scale before transferring the payroll to county governments," Governor Njuki said.
"Since the contracts are still valid, the decision to transfer staff at this time is premature. The verification report has not been validated and officially shared, and therefore, the process is not agreed upon.
"On gratuity, Governor Njuki was unequivocal. "UHC staff on contractual terms are entitled to gratuity. The ministry should settle all gratuity payments before they transition to county governments."
He said the Council of Governors reiterates its commitment to absorb verified UHC staff once resources are disbursed and gratuity obligations honoured.
"Failure to which, the absorption will be unattainable," he warned, reminding CS Duale that the Constitution requires both levels of government to relate on the basis of consultation.
