UHC workers protest six-year wait for job security
A section of health workers employed under the Universal Health Coverage (UHC) programme protest outside the National Treasury Building in Nairobi on May 27, 2025.
Thousands of Universal Health Coverage (UHC) workers protested outside the Ministry of Health offices on Wednesday, many still in their work uniforms, demanding a future they say the government keeps promising and never delivers.
Their contracts expired on June 30, their July salaries are in doubt, and six years after many of them first reported for duty at the height of the Covid-19 pandemic, they say they are being treated as though they no longer matter.
Henry Adeka, a UHC worker from Taita Taveta County, says his contract, like those of 7,000 others, lapsed in June. Since then, he says, there has been no letter and no formal communication; just verbal instructions to keep showing up for work.
"Why are they treating us like lesser children of a lesser God? The only thing we are told is to go back to work verbally. But there's no official commitment from both the national and the county governments," he said while protesting at Afya House.
"They've been telling us that they are sorting out our issue three years down the line. Now the contracts are over, but they are still sorting out the issues. Our question is, up to when are they going to sort out our issues? We've been drained financially and economically, and we can't even provide for our daily needs. We are growing old; we have families and children that we are struggling to provide for. Some of our colleagues can no longer afford school fees for their children or support aging parents and siblings," added Adeka.
Health Cabinet Secretary Aden Duale before the National Assembly health committee at Parliament buildings in Nairobi on May 15, 2025.
What stung most, he said, was watching Cabinet Secretary for Health Aden Duale ignore them and drive off, weeks after personally promising the matter would be resolved within two weeks.
"Today, he had the guts to throw hands at us. Adding insult, he said, interns are being handed contracts even as UHC staff are left with nothing," said Adeka.
For Miriam Wachira, the toll has been just as personal. Her contract lapsed on May 22, and her employment formally ended on June 30. Without an active contract, her family's health cover has lapsed too.
"If the children get sick, we have nowhere to take them because our coverage automatically expired as soon as our contracts did," she said.
Wachira said she understood that funds meant for UHC salaries exist but blamed county governments for refusing to commit to spending them.
"There is money allocated, but the governors have refused. They don't want to commit themselves to anything. We are still owed our gratuity for the six years of service already rendered. The government has told us that we have to be employed, so I think we have to be employed," she said.
Universal Health Coverage (UHC) workers protest outside the National Treasury Building in Nairobi on May 27, 2025.
For Guyo Arero, also from Taita Taveta, the frustration runs deeper than missed pay. Arero was among those who left their homes to work the frontline of Kenya's Covid-19 response in 2020. Six years on, he says, the promises made then have curdled into something closer to captivity.
"We have been put in jail. Right now, the payslip has stopped. Right now, we can't go to the hospital because our health coverage has stopped. Some workers are now facing eviction, unsure how they will cover rent. We are in jail. We have been in jail for six years," he said.
Arero recalled the Health CS telling residents in Kajiado that UHC workers would be moved to permanent and pensionable terms, a promise that has yet to materialise.
"The governors should understand us. Give us our PnP letters and confirmation so that we can go back and serve the people we were serving. We know that money was provided for our employment in this year's budget," he said.
Shiru Kihara, a UHC staff representative, laid out the timeline of broken commitments in detail. The earliest contracts in the current cohort lapsed in April, were extended, and then finally expired on June 30, all on the understanding that permanent and pensionable letters would be issued from July 1. That date came and went with nothing to show for it.
"For the last six years, we have been having the same kind of communication. I acknowledge that there has been some progress since the current Cabinet Secretary took office last year. But it becomes difficult to trust what he is saying because when we called off our strike last year, it was with a promise that by July 1, we would be permanent and pensionable. But July 1, came and passed, and we are not still permanent and pensionable," Shiru said.
According to Shiru, ministry officials say most issues have been resolved except the reclassification of the funding that pays UHC salaries. The money currently arrives as a conditional grant, which the Council of Governors insists is a one-year commitment with no guarantee of renewal. The proposed fix is to move the funding into the equitable share allocation, a change that requires an amendment by the Senate. Shiru said the ministry has assured workers that the Senate has agreed to make the change, though she remains sceptical given that the Senate is currently on recess.
"They are promising us that our salaries will be paid by the end of this month. But then if they are on recess, how will that happen?" she asked.
She also pointed to an unresolved headcount. Workers were told their names would be published to guarantee that everyone on the current payroll would carry over once responsibility shifted to the counties, but the list has never appeared.
Universal Health Coverage (UHC) workers protest outside the National Treasury Building in Nairobi on May 27, 2025.
Shiru said the last set of county staffing returns was only submitted on the 5th of this month, with no confirmation that publication will follow. Her distrust, she said, is rooted in history, during a protected strike last year, some union members were dropped from the payroll altogether.
"It's been more than a year of them being outside the payroll," she said, adding that even after officials claimed those workers had been restored, the affected individuals say otherwise.
"You see, it becomes really difficult to trust what they are saying. Do they even need our services? We have served the county governments very well, but it's as if they don't want us," said Shiru.
Addressing the protesting workers, James Ntabo, speaking on behalf of the Health ministry's top leadership, struck a more conciliatory tone, telling workers that a resolution was close and thanking them for their service through the pandemic and beyond.
"The budget is there," Ntabo told the workers, adding that the ministry is now waiting on the Senate to formally move the money out of conditional-grant status so it can be paid out under permanent and pensionable terms.
The ministry's written statement, issued on July 6, said the Public Service Commission had extended workers' contracts through June 30, specifically to allow time for the transition to be finalised. The statement pointed to progress by a multi-agency committee overseeing the process, including efforts to reclassify funding from the county governments' additional allocation framework into the Division of Revenue Act framework, and pledged that absorbed workers would be paid according to scales set by the Salaries and Remuneration Commission.
Despite this, patience has run out for the Kenya Environmental Health and Public Health Practitioners Union (KEHPHPU), which this week issued a formal 14-day strike notice to the Ministry of Health and the Council of Governors.
Read: Duale: I’ll rehire all 7,414 Covid medics in referral hospitals if governors refuse absorption
The union cited three unresolved grievances: the failure to issue permanent and pensionable letters to UHC officers despite the government's own July 1, commitment, the failure to conclude a centralised recognition agreement with the union, and the failure to conclude a collective bargaining agreement covering pay and conditions for public health officers, specialists and technicians nationwide.
The union has given the ministry and county governments 14 days to meet its demands or face nationwide industrial action.
The pressure is echoed at a broader level by the Kenya Health Caucus, an umbrella body chaired by Peterson Wachira and made up of six health-sector unions. The caucus acknowledged Parliament's approval of Sh8.9 billion in conditional grants for UHC salaries in the 2026/2027 budget but said this does not solve the underlying job insecurity.
"We note that in the 2026/2027 Budget Estimates approved by Parliament, Sh8.9 billion has been allocated under conditional grants for the payment of salaries for UHC staff for one year. While this allocation is appreciated, it does not provide a sustainable solution to the long-standing issue of employment insecurity facing UHC and Global Fund workers," said Wachira.
"In light of the foregoing, the Health Union Caucus demands immediate absorption of all UHC and Global Fund staff into Permanent and Pensionable (PnP) and issuance of appointments; Parliament to include the allocated funds through an equitable share framework rather than annual conditional grants, which are unsustainable and continue to expose UHC and Global Fund workers to uncertainty and job insecurity; and the Health Union Caucus to be actively involved in engagements regarding the transition of UHC and Global Fund workers into permanent and pensionable terms," added Wachira.
The fallout is already visible at county level. In a memo dated July 7, Julius Ng'ambi, Chief Officer for Medical Services in Nyandarua County, acknowledged that the expiry of UHC contracts had left "substantial human resource gaps" across the county's health facilities, with 154 UHC health workers in Nyandarua alone having stayed away from their duty stations, "thereby placing immense pressure on the remaining workforce and threatening the continuity, accessibility and quality of essential healthcare services."
To keep services running, Ng'ambi recalled all officers currently on annual leave back to duty with immediate effect, promising that their interrupted leave days would be rescheduled without loss of entitlement once staffing stabilises.
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