Nurses from health facilities in Uasin Gishu County during the launch of their strike in Eldoret City, Uasin Gishu County on December 23, 2024.
Nurses have given the national government a week to address their grievances, including provision of comprehensive medical cover and conversion of those on contractual terms to permanent staff, or they down their tools.
The development comes after two of the nurses’ unions, the National Nurses Association of Kenya (NNAK) and Kenya National Union of Nurses and Midwives (KNUN), said they were ready to proceed on strike starting January 19, 2025 should the government fail to listen to them.
NNAK President Collins Ajwang’ on Sunday said Kenya’s nurses had tirelessly borne the brunt of systemic neglect and discrimination, yet they remain the backbone of healthcare delivery.
He maintained that the nurses would no longer accept the persistent injustices and systemic failures affecting them and midwives.
“We urge the government and all stakeholders to move with speed to resolve all the nurses’ grievances before January 19, 2025,” said Mr Ajwang’. “Failure to address the grievances, these nurses will down tools on the same day.”
He explained that one of the grievances they want addressed is the conversion of the approximately 2,700 universal health coverage (UHC) nurses recruited in 2020 on contractual terms to permanent and pensionable terms to strengthen health services.
Mr Ajwang’ said that despite their critical role, the UHC nurses face glaring disparities in remuneration and benefits compared to their counterparts in permanent and pensionable terms.
He argued that the nurses have been excluded from critical allowances such as nursing service allowance, commuter allowance, health risk allowance and uniform allowance.
“We want immediate absorption of the nurses to permanent terms as well as settlement of unpaid May 2024 salaries for the first cohort. This is in addition to retrospective payment of allowances owed to UHC nurses since their recruitment,” he said.
He also called for the establishment of a transition committee with clear timelines to oversee the transition process including representatives from the two Unions.
For his part, KNUN Secretary-General Seth Panyako cited the issue of acute shortage of nurses with the country’s healthcare in need of 50,000 nurses urgently to meet World Health Organisation’s recommended nurse-to-patient ratio.
He said the shortage has led to overburdened healthcare workers, compromised quality of care and patient outcomes as well as increased burnout and attrition among nurses.
“The government should prioritise funding for nurses recruitment in the national budget as well as develop a national workforce planning framework to address future shortages,” he said.
Mr Ajwang’ demanded that the President William Ruto’s government provide comprehensive insurance cover to nurses as part of the Social Health Insurance Fund (SHIF), raising concerns over too high deductions from nurses despite minimal services covered.
He added that a review of the implementation framework of the Fund is needed as its poor implementation has led to minimal access to services.
“The transition from NHIF to SHIF without proper transitional framework has occasioned a lot of frustrations to the nurses and other healthcare workers. There is a need to have comprehensive health cover for the nurses who are a critical component,” said Mr Ajwang’.
Over to counties, the two officials raised concerns over the failure by most of the devolved units to implement a 2017 return to work formula signed at the national level as well as non-payment of arrears and allowances captured in the CBA, perpetuating inequalities in pay, benefits and working conditions.
“We want full implementation of the agreement and equitable remuneration practices to standardise pay scales across counties,” Mr Panyako said.
On the other hand, Mr Ajwang’ called on the county government to expedite the implementation of the 17-tier grading system for seconded staff from the Ministry of Health.
He said the system offers clear career progression pathways and equitable remuneration, however, some counties are yet to implement the system leading to stagnation and demoralised nurses.
The situation, he said, has led to disparities in grading and remuneration between nurses working in the national government and those in counties.
Further, the NNAK boss wants the operationalisation of the Directorate of Nursing Services (DNS) as captured in the Health Act 2017 and its immediate recognition of its roles by counties with adequate resources allocated to support its operations and initiatives.
He said that standardised DNS roles will ensure uniformity in nursing services across all the 47 counties.
