For 43 days, public hospitals across Kenya fell unusually quiet. Expectant mothers in labour were turned away at hospital gates, families scrambled to raise money for private treatment, and a healthcare system already under strain buckled under the weight of a dispute that had dragged on for more than a decade.
By early September, human rights monitors were sounding the alarm over a mounting humanitarian toll, recording scores of preventable maternal, neonatal and perinatal deaths across county wards.
The breakthrough came yesterday, September 9, 2026, at the Council of Governors' (CoG) offices in Nairobi, when Kenya National Union of Nurses and Midwives (KNUNM) Secretary-General Seth Panyako called off the strike and directed nurses to return to work within 24 hours of the 3pm announcement.
"I hereby declare that the strike that commenced on July 29, 2026 is hereby called off. I hereby direct members to resume duty immediately, and in any other case, not later than 24 hours from now," Panyako announced.
The announcement followed the signing of a return-to-work formula, forged after intense, high-stakes negotiations involving Panyako, union chairperson Joseph Ngwasi, treasurer Maureen Nzioka, CoG chair and Wajir Governor Ahmed Abdullahi, CoG Health Committee chair Abdulswamad Shariff Nassir, and Nandi Governor Stephen Sang.
"Going on strike in the health sector is not something we would like to have. And moving forward, we would like to discuss our issues without necessarily subjecting Kenyans to suffering and death. I want to urge all leaders who are responsible for managing health in this country to ensure that all problems are resolved not only for nurses, but for all healthcare workers," said Panyako.
Nurses call off their 43-day strike
The nationwide strike, which began on July 29 and involved more than 42,000 nurses, was driven by a series of unmet promises. Key issues included the failure to implement parts of the 2017 return-to-work agreement, delays in negotiating a centralised 2025–2029 Collective Bargaining Agreement (CBA), the dismissal of 46 Kisii County nurses during a 2021 strike, delayed career progression guidelines, and the continued reliance on short-term contracts for thousands of Universal Health Coverage (UHC) workers.
Kenya National Union of Nurses and Midwives Secretary General Seth Panyako address journalists after signing a return-to-work formula that ended the nationwide nurses’ strike at Delta Towers, Nairobi, on September 9, 2026.
Photo credit: Lucy Wanjiru | Nation
Ending the stalemate required hard-fought compromises on both sides. County governments agreed to raise the monthly risk allowance from Sh3,850 to Sh8,000 and the uniform allowance from Sh10,000 to Sh15,000, effective July 1, 2025. Devolved units also pledged to absorb all UHC staff onto permanent and pensionable terms starting in the 2026/2027 financial year, and committed to establishing a model career framework within 45 days.
In exchange, KNUNM agreed to immediately call off the strike, direct nurses back to work within 24 hours, and give county leadership a 45-day window to finalise the comprehensive CBA without the threat of further industrial action.
"We have been negotiating, and finally I can say we have a mutually acceptable return to work formula. The parties agree to continue with the negotiations and conclude the Collective Bargaining Agreement within 45 days from the date of execution of this RTWF," said CoG chair Abdullahi.
He said the reinstatement of the 46 dismissed Kisii nurses would be handled through talks between the county government and the union, and that no nurse would be punished for taking part in the strike. UHC workers, he added, would receive their accrued gratuities once confirmed on permanent and pensionable terms.
From left: Mombasa Governor and Council of Governors Health Committee Chair Abdullswamad Sherrif Nassir, Wajir Governor and Council of Governors Chair Ahmed Abdullahi, Kenya National Union of Nurses and Midwives Secretary General Seth Panyako and Kenya National Union of Nurses and Midwives (KNUNM) Chair Joseph Ngwasi display the signed return to work formula following an agreement that ended the nationwide nurses strike at Delta Towers, Nairobi on September 9, 2026.
Photo credit: Lucy Wanjiru | Nation
What had stalled the deal for nearly a decade was a mix of severe fiscal constraints and administrative friction. Governors repeatedly pointed to tight revenue-sharing allocations, arguing that signing a CBA and absorbing billions of shillings in backdated allowances across 47 counties would cause recurrent budget shortfalls, unless national allocations were expanded and the Facility Improvement Fund (FIF) was fully operationalised.
"When a strike occurs, especially when it is a matter to do with health, it's actually the millions of Kenyans out there who suffer. We have gone out of our way to understand the plight of the medical workers, the nurses. At least now, there's a notch in our priorities that is being offered to the nurses. I truly hope that this is going to be one of the last strikes that we will be dealing with," said CoG Health Committee chair Abdulswamad Shariff Nassir during the signing.
Addressing the financial deadlock that had prolonged the crisis, county leaders said the union's original demands far exceeded what counties could afford. Initial claims based on the 2017 agreement had tallied over Sh6 billion, built on proposed risk allowances of up to Sh15,000.
"The stance that the union had proposed on the figures was way higher. It was impossible for us to be able to raise this kind of money. The Sh6 billion was based on the fact that, in the last conversation, we were stuck between our offer of Sh7 billion and their request for Sh15 billion. Now, we have about 42,000 nurses in this country. Before signing this, they were earning Sh3,850. Now that has been increased to Sh8,000. From around a figure of about Sh6 billion, we are now looking at about 1.8 billion," explained Nassir.
"How are we going to raise this Sh1.8 billion? Through the Facility Improvement Fund. Laws were put into place; that money for health needs to be put aside and just be utilised for health alone... Several counties have started seeing an increase in their own-source revenue because of health. We will take advantage of that," Nassir added.
The settlement also averted a broader system collapse after the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) issued a seven-day strike threat on Monday, citing extreme burnout among doctors working without nursing support.
Nurses from Kisumu, Siaya, Homa Bay and Migori counties take part dancing, chanting and singing during a joint procession in Kisumu on August 27, 2026, in solidarity with the ongoing nurses’ strike.
Photo credit: Alex Odhiambo | Nation
While CoG leaders said they had received no formal strike notice from doctors, Nassir acknowledged reaching out to union officials informally.
"We heard it from the media, but I took the liberty of reaching out to union leaders, and they did indicate that yes, doctors have been complaining that without nurses it becomes a burden. Back-channel engagements are ongoing to ensure clinical services remain fully operational," said Nassir.
Addressing reports of rising maternal and neonatal deaths during the 43-day strike, Governor Abdullahi pointed to existing policy tracking systems, while cautioning that the raw numbers tell a more nuanced story.
"We have something called MPDSR [Maternal and Perinatal Death Surveillance and Response]. One death is one too many, but death is part of life. Needless to say, when a strike happens, it affects service delivery. But counties have made a conscious effort to fight maternal and neonatal deaths as a policy. In fact, the MPDSR effort was ours at the beginning... As a result, we've actually had counties that have gone for several months without recording any deaths within their system," said Abdullahi.
Nassir confirmed, however, that the CoG would launch a formal stock-taking exercise to audit facility deaths recorded during the strike period.
"What we are going to do as a Council is also take stock of what exactly caused these deaths. We are not saying the strike did not lead to any deaths, but we want to take stock to establish whether they were preventable and whether the strike directly contributed to them," Nassir said.
Welcoming the return-to-work deal, KNUNM chairperson Joseph Ngwasi called for a permanent shift toward proactive dialogue to ensure public health is never again held hostage.
"I want to take this opportunity to thank the leadership of the council for engaging us. We have been engaging formally and informally to end this crisis. As a union, we have embraced alternative dispute resolution mechanisms. Moving forward, we urge the employer that we engage before we get a deadlock, and we are open to dialogue," Ngwasi said.
With nurses stepping back into emergency rooms and maternity wards across all 47 counties, millions of Kenyans can finally breathe a sigh of relief, even as the clock begins ticking on the 45-day window to seal the final CBA.
