A patient lies unattended in the emergency unit at Kisumu County Referral Hospital on Wednesday, July 29, as the nationwide nurses’ strike took effect. Most patients at the hospital had yet to receive nursing care following the start of the industrial action.
Nurses, laboratory officers, public health officers, nutritionists, pharmaceutical officers and clinical officers are currently on strike across the country. The industrial action by the various health worker cadres began last week, on July 20, and nurses joined in yesterday, adding to a growing wave of strikes that has paralysed services in public hospitals.
Union leadership points fingers directly at the Salaries and Remuneration Commission (SRC) and the Council of Governors, accusing them of blocking progress on long-standing issues affecting nurses.
The strike is affecting services including laboratory testing and sample analysis, dispensing of medication at hospital pharmacies, nutritional counselling and therapeutic feeding programmes, public health surveillance and disease reporting, clinical consultations and minor procedures, and nursing care such as wound dressing, medication administration and patient monitoring. As a result, the sick are being left to either wait indefinitely, seek expensive private care they cannot afford, or go home untreated.
Seth Panyako, Secretary General of KNUNM, told Nation that more than 32,000 nurses, excluding those from Kenyatta National Hospital (KNH), have downed their tools immediately. Nurses from KNH will begin their strike from July 31.
By 2.30pm yesterday, 22 counties had confirmed through their leaders that they were already on strike. They are Kitui, Samburu, Wajir, Machakos, Kajiado, Tharaka Nithi, Kisii, Bomet, Makueni, Meru, Murang'a, Kisumu, Bungoma, Homa Bay, Kwale, Nyamira, Siaya, Uasin Gishu, Embu, Lamu, Mombasa and Nyandarua.
The nurses will today hold a peaceful procession in Nairobi, starting from the Green Park bus terminus, proceeding to the Health ministry's offices and then to the Council of Governors' offices in Westlands.
Panyako told Nation that the stonewalling from SRC on their grievances appears to be personal, and they feel left out.
"Clinical officers and the doctors have all been honoured and their CBA approved by the Salaries and Remuneration Commission, but when it comes to nurses, the SRC has a tendency of fighting us; we don't know whether they hate nurses or they have personal difference with union leadership," he said.
"SRC is committed to ensuring that nurses are not at peace in their place of work. We are going to give them what they want," he added.
Kenya National Union of Nurses Secretary-General Seth Panyako.
Lucy Mburu, Assistant Secretary General for KNUNM and branch secretary for Murang'a County, said the Council of Governors (CoG) had agreed to meet them about two months ago, but rescinded after initiating the process.
"We met the representatives from the CoG, and even before we ended the process, they terminated it unceremoniously without informing us," she said.
"They were to give us feedback in two weeks, but they went mute. We followed up even physically at the CoG offices, but we got no reply; that is why we issued a seven-day strike notice," she added.
Among the issues raised by the union leaders is the Council of Governors' failure to negotiate and conclude the centralised 2025–2029 Collective Bargaining Agreement (CBA) for nurses and midwives. They say the delay denies nurses and midwives better terms of service and equitable compensation.
They also say counties have yet to implement the Career Guidelines for Nursing Personnel, despite the Public Service Commission (PSC) advising county governments to customise and adopt the career guidelines it approved in March last year.
Ms Mburu explained that nurses are still using the 2014 Scheme of Service for Nursing Personnel, even though a lot has changed over the years. The new career guidelines change the entry point for a nurse: while the previous scheme's entry point was job group H, the new one is job group J. The latest guidelines also recognise nursing specialities such as nurse anaesthetists, critical care nurses and Intensive Care Unit nurses. Mburu also told Nation that the old scheme did not recognise a Bachelor's Degree in nursing as a career advancement, especially for nurses who started with a diploma; the new guidelines recognise this advancement.
In 2017, the nurses signed a Return-to-Work Agreement that they say has been ignored for almost a decade now. They now want a change to this agreement to allow for an adjustment in their allowances.
Mr Panyako said some of the new adjustments needed include an increase in the uniform allowance from Sh10,000 to Sh25,000, the nursing service allowance from Sh20,000 to Sh30,000, and the risk allowance from Sh3,850 to a figure not yet agreed on, but higher than the previously proposed Sh5,000. He noted that nurses get the least amount of risk allowance compared to other cadres.
"When you look at the factors used to determine the amount of risk in the health sector, nurses are 30 times more at risk than any other health worker," he said.
We reached out to SRC chairperson Sammy Chepkwony, who said the commission is now ready to meet KNUNM.
On the 2025–2029 CBA, Mr Chepkwony said the matter is currently before a conciliator, the Ministry of Labour and Social Protection, and that he is confident it will be resolved amicably. He added that the commission has already provided advice to 12 counties on the CBAs for the 2021–2025 cycle and is currently reviewing CBAs for two more counties, as it awaits submissions from the rest.
"There are indications that county governments are planning for a joint CBA for the 2025-2029 for all counties. SRC stands ready to support the process by providing advice upon receipt of submissions from counties," he said.
In Homa Bay, nurses joined the strike, piling pressure on the county government to address the same long-standing grievances affecting their welfare and service delivery
KNUNM Executive Secretary Emmadick Otieno and Trustee Bonfance Oudia said Homa Bay nurses intend to issue a separate county strike notice once the nationwide boycott ends if their local grievances remain unresolved.
Mr Otieno said nurses in the county would only resume duty once their concerns had been fully addressed. He noted the union had reached a return-to-work agreement with the county government in April, after suspending an earlier strike, but said several commitments made by the devolved unit had yet to be honoured.
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"Nurses will only return to work once our issues are addressed. I will serve the county government with a county-based strike notice until all the issues contained in the return-to-work agreement are fully implemented," he said.
Mr Oudia urged residents with patients admitted to public hospitals to consider transferring them to private health facilities where possible.
"Patients who are stable should be discharged, while those who still require medical care should be transferred to other facilities," he said.
Universal Health Coverage workers protest along Uhuru Highway in Nairobi on May 20, last year, during an earlier demonstration over their delayed absorption.
At Homa Bay County Referral Hospital, beds in the wards remained occupied on Wednesday as anxious caregivers weighed the difficult decision of moving their loved ones to alternative hospitals.
In Nyandarua County, Nurses Union secretary James Maina confirmed the strike had begun paralysing health services.
"All the 455 nurses from Nyandarua are not working. The strike is successful. But we have only one issue with the county government, which is employing nurses on contract. All the other issues can only be handled by the national government; that is why the strike is called by the national office," Mr Maina said.
In Nakuru, Rose Masita, chairperson of the National Nurses Association of Kenya (NNAK), Nakuru chapter, said the strike had not yet begun, adding that the union had already served the County Government with a strike notice.
In Bomet County, there was a go-slow among nurses at Longisa County Referral Hospital, as well as at Tegat, Sigor, Ndanai, Koiwa and Kapkoros sub-county hospitals.
In Kericho, the county government moved to avert a looming strike by signing a Recognition Agreement with the Kenya Medical Laboratory Technicians and Technologists Union (KMLTTU), led by Secretary General Nyakundi Moriasi Pius.
KNUNM leaders are also standing in solidarity with nurses in the Universal Health Coverage (UHC) cohort who are yet to receive permanent and pensionable letters, despite the National Treasury's budgetary allocation. So far, they have only been told that their payslips now read permanent and pensionable, but they are not sure if that has any impact on their future.
Immaculate Njoki, one of the affected UHC nurses, said they have been on the streets for so long waiting to be absorbed, but there is no assurance since they don't have letters.
"We have been stuck in the same job group since 2020; we need to be taken to the next job group," she said.
When the nurses held a nationwide strike in 2021, the County Government of Kisii failed to reinstate 46 nurses and wrongfully dismissed them while on duty. The union now wants the county to re-employ these nurses.
Patients across the North Rift were left stranded on Wednesday after nurses and clinical officers downed their tools in a nationwide strike, paralysing services in public hospitals and raising fears of a deepening healthcare crisis.
The industrial action has disrupted services in public health facilities across Trans Nzoia, Uasin Gishu, Nandi, Elgeyo Marakwet and Turkana counties, with unions warning that private hospitals could become overwhelmed as patients seek alternative treatment.
In Nandi County, KNUCO branch secretary Joan Kitur criticised county governments for failing to address persistent labour grievances, including delayed salaries, stalled promotions and lack of comprehensive medical cover.
Uasin Gishu, KNUN branch secretary Kleen Kimtai demanded implementation of the 2017-2021 uniform CBA, the 2017 Return-to-Work Formula, payment of salary arrears and structured career progression.
Turkana Health executive Dr Joseph Epem, Chief Officer Dominic Emase and Lodwar County and Referral Hospital Chief Executive Officer Nancy Kinyonge held talks with union representatives in a bid to cushion patients from the effects of the strike. In Trans Nzoia, more than 500 nurses announced they would join the nationwide strike.
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Additional reporting by George Odiwuor, Vitalis Kimutai, Mercy Koskei, Barnabas Bii, Evans Jaola, Sammy Lutta and Waikwa Maina
