Patients suffer as counties threaten mass dismissals of striking workers
A police officer gives orders to protesting Universal Health coverage (UHC) workers outside parliament buildings in Nairobi on May 21, 2025.
Striking 8,571 health workers have disrupted operations in hospitals nationwide with patients bearing the brunt as county authorities warn of looming dismissals.
Emergency departments are operating with skeleton crews, maternity wards are struggling to deliver basic care, and laboratory services are facing critical delays as the 17 different medical cadres maintain their protest over unfulfilled promises of permanent employment and unpaid gratuity.
County governments, watching their healthcare systems crumble, have responded with an ultimatum: return to work or face dismissal. Universal Health Care (UHC) workers are receiving a flurry of show-cause letters as county officials escalate pressure through formal disciplinary proceedings.
"The Department of Health Services has noted with concern that many healthcare workers, particularly those engaged on UHC contracts, have abandoned their duty stations in the recent past," states Dr Betty Langat, Kericho county's health director, in an official memo obtained by the Nation. "This has resulted in unprecedented, yet avoidable delays in our various facilities to the detriment of our clients."
The comprehensive UHC workforce includes direct patient care providers like doctors, nurses, clinical officers, pharmacists, laboratory technicians, dentists, occupational therapists, physiotherapists, nutrition officers, and public health officers. But there are other critical support staff like managers, ambulance drivers, and accountants whose absence compounds operational challenges.
In Kirinyaga County, facility managers are issuing individual ultimatums to striking workers. Margaret Ndinwa, facility-in-charge at Difathas Health Centre, warned one UHC nurse that her "prolonged absence has caused significant disruption of services at the facility, thereby affecting service delivery to the community."
"This conduct constitutes negligence of duty, which is a serious breach of your responsibilities as a health worker," Ndinwa stated in a show-cause letter, demanding written explanations and threatening disciplinary action by month's end.
Coordinated action
Meanwhile, in Elgeyo Marakwet County, Jeremiah Chirchir, head of clinical services, has directed sub-county officials to compile comprehensive lists of absent UHC staff, signalling coordinated county-level action against the striking workers.
The escalating standoff threatens to permanently fracture Kenya's healthcare workforce just as the system struggles to recover from years of pandemic-related strain.
In Tana River County, health officials are equally grappling with the same headache.
“Following a consultative meeting on UHC staff held on 6th May 2025, you are required to resume work with immediate effect and not later than 7th May 2025,” an internal memo in Nation’s possession that was sent to all UHC staffers in the county reads.
However, to date, not a single one of them has reported to work further fuelling the crippling of services like maternal health care as well as clinical services.
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In Samburu County, Josphat Lenguris, the chief officer of medical services, is having sleepless nights. “The county department received your strike notice, which commenced on midnight of 16th March 2025.
"Following a series of meetings with your representatives a consensus and way forward was agreed on how to solve UHC issues,” he started in an internal memo.
“Therefore, the department requests all the UHC staff to be back on duty as the department continues to work on your issues; failure to report back for duties as stipulated will lead to the stoppage of your salary and disciplinary process to follow,” he said.
In Nandi County, Health and Sanitation CEC Fred Kiptum, in an official memo, ordered all UHC staffers to report back with immediate effect and show up for a head count.
“Following the high-level consultative meeting between MoH and the Council of Governors (CoG), it was resolved that counties undertake a head count of the UHC workers to enhance accountability,” he explained.
Mr Ibrahim Adan, the chief officer in the department of medical services and public health in Nyeri County an official memo to all UHC staff and their supervisors titled ‘absenteeism without lawful cause’, threatening to take disciplinary action against all the UHC medics missing work.
“The office has been reviewing the work station duty rota and receiving daily reports, and has noted that some of the UHC staff have been absent from duty without lawful cause.
Please note that this is contrary to the employment contract and constitutes misconduct,” he pleaded with the health workers whose vital services are depended on by Nyeri residents.
In Kakamega Country, Dr David Alilah, the chief officer of medical services, directed all UHC staff to immediately pick up their tools and resume work.
“You are required to submit a list of all UHC staff in your facilities who have not resumed work,” he directed all sub-county officials.
However, speaking to Nation on Monday, UHC national chair Desmond Wafula said none of the over 8,000 health workers will comply with any county official because they are employed by MoH and not counties.
“County officials have time and again reminded us that our employer is the MoH because our payroll is with the health ministry. Why are they issuing threats and trying to intimidate health workers they did not hire and do not pay?”
“The 8,571 have for the last five years been offering services Kenyans depend on, all we are asking for is that government sorts out our gratuity as well as permanent and pensionable terms after which we shall resume work because for the last five years we have been lied to and made to suffer like children of lesser gods, made to work more than our counterparts who do the same work with nothing to write home about, we are not beasts of burden,”he added.
While responding to queries filed by Nation over the threats and intimidation countries have been issuing to the protesting UHC medics, CoG chair, who is also Wajir Governor Ahmed Abdullahi said they are having a hard time.
“We are having a hard time holding UHC medics who miss work accountable because their employer is the health ministry, and when we officially write to MoH demanding action be taken, we are directed to go and talk to treasury,” he said.
Speaking in Garissa on Sunday, Health CS Aden Duale maintained that he will transition UHC staffers to permanent and pensionable terms and ensure they are absorbed into counties once the Senate and National Assembly make available the Sh4.2 billion he urgently needs to do so.
“On UHC medics, we have agreed with governors, the problem is some people want me to make popular decisions.
No, I will make the right decisions,” he said.
“I have spoken to the Senate and also the National Assembly, if they make the Sh4.2 billion available by July this year, together with the Governors, I will transition the UHC staff whom I have a lot of respect for to permanent and pensionable, “the CS assured.
However, while reacting to Mr Duale’s sentiments, Mr Wafula asked the CS to keep in mind that their issues have been mishandled by his past three predecessors, who promised manna and quails then delivered nothing.
“On Tuesday this week, were are camping outside Afya House, day and night, at least 3,000 of us drawn from all over the country for our 21st protest over the same issues.
We have been subjected to a lot of suffering, psychological torture that have resulted in the death of 46 of us with many taking their own lives due to depression brought about by empty promises and rhetoric for the last five years, we have had enough and won’t resume work until PnP and gratuity is fully sorted,” the UHC national chair told Nation.
