Hundreds of Health workers participate in a demonstration in Nairobi on April 9, 2024.
The 8,571 universal health coverage (UHC) medics who were deployed on Covid-19 frontlines with promises of gratuity as well as permanent and pensionable terms (PnPs) have announced plans to down their tools on Monday next week.
The health workers intend to camp at Afya House day and night until their demands are met.
They argue that despite risking their lives during the pandemic, with many succumbing to the virus, the Health Ministry's latest decision to transfer them to counties without addressing their concerns violates their rights.
Many of the healthcare workers, who have remained on a "special" stagnant salary for five years, have reportedly sought psychological help due to the stress.
"Our pay remains unchanged except for an extra tax, yet we're still expected to perform at full capacity," one of the medics told Nation on Wednesday.
They also expressed concern that Health Cabinet Secretary Aden Duale rushed to announce that they had agreed to work under unfavourable conditions, yet no return-to-work formula had been signed with their actual union representatives.
Health Cabinet Secretary Aden Duale addresses journalists at Afya house, Nairobi, on April 17, 2025.
This comes after a Tuesday meeting where CS Duale met with Council of Governors (CoG) CEO Mary Mwiti, and health sector unions represented by Kenya National Union of Nurses Secretary General Seth Panyako.
During the meeting, the government announced that effective July 1, 2025, it would transfer the payroll management of UHC staff to county governments, along with the necessary budget to sustain the current stipend terms during the transition.
"Before the expiry of current contracts, county governments will receive additional funding to facilitate the full absorption of UHC staff into permanent and pensionable terms. Furthermore, service gratuity payments will be considered at the conclusion of the absorption process," CS Duale said.
However, Desmond Wafula, the national UHC staff chairperson, revealed that he was not invited to the meeting at the Health ministry. He contends that any agreement reached by Mr Panyako with the government is invalid.
"It is very unfortunate that Dr Ouma Oluga, the new PS for Medical Services and a renowned and respected unionist who even crafted the 2017 KMPDU collective bargaining agreement (CBA), was part and parcel of a meeting designed to oppress us and force us to go back to work without any return-to-work formula. He has totally misadvised the Health CS on this matter. As from Monday next week, all UHC staffers will down their tools and camp at Afya House day and night, hold vigils until what we were promised is delivered and our rights respected," Mr Wafula told Nation.
He disclosed that they are giving CS Duale's team two options.
The Afya House which hosts the Ministry of Health in Nairobi.
"Option one, each UHC medic must be issued a PnP appointment letter as our payroll gets transitioned from Health ministry to counties. In this case, we are willing to continue with the current consolidated salaries despite them being far below market rates as per the Salaries and Remunerations Commission (SRC) while awaiting the full transition to PnP terms, provided the payroll has to be transferred to counties in the said month of July," Mr Wafula said.
"The second option is that UHC staffers must receive full salaries aligned to current market rates as determined by SRC. In addition, a legally binding agreement must be signed by all relevant parties including UHC representatives, the Health ministry, CoG, and health unions clearly outlining the terms of absorption and specific implementation timelines with the gratuity payments for transparency purposes," he stated, adding that if these conditions are not met, all UHC staffers will continue their nationwide strike and protests until the government addresses their concerns."
How the crisis began
In 2020, at the height of the coronavirus pandemic, the government deployed approximately 9,000 health workers under the UHC program to address a severe shortage in the healthcare workforce.
"We were deployed across the 47 counties of the country to serve the nation, and some of us like the late Dr Stephen Mogusu even died before getting their first salary," Wafula recalled.
"With time, the number of Covid-19 cases decreased, we hoped that the government would reassess our service terms as a gesture of appreciation post-pandemic as the then Health CS Mutahi Kagwe had promised in writing. We were mindful of the challenging economic circumstances brought about by the pandemic at the time of deployment; hence, we prioritised putting lives first and selflessly offered our services as patriotic citizens," he said.
"Little did we anticipate the ensuing struggles that have now gone into the fifth year, culminating in protests and urging the government to honour its promises but instead President Ruto's government keeps lying to us with a straight face," Wafula told Nation.
He narrated how his members are now grappling with mental health issues as a result of frustration by the Health ministry, with at least 10 having taken their own lives due to depression.
"An agreement was signed during the 'Kericho Declaration' that our terms shall be transitioned to permanent and pensionable as we are in service on contract terms, receiving half pay salary with no allowances or salary increments and subject to all deductions that may arise. It is shocking that county governments have been continuously advertising various health positions, excluding staff under the UHC programme while some positions go to girlfriends and relatives of county officials," he further disclosed.
"The opposite"
On July 11, last year, the Senate committee in charge of Health held a meeting with then-Health CS Susan Nakhumicha, CoG represented by Governor Johnson Sakaja, and UHC staffers regarding the same issue.
Governor Sakaja at the time proposed that the contracts of the UHC staff be further renewed for three years as per the agreement reached during the first inter-governmental retreat held in February 2023 under the same terms (half pay salary and no salary allowances) as CoG and the Health Ministry worked to absorb the UHC staffers to PnPs.
"Ironically, this has been the opposite of what all the governors have been doing including himself during the deployment of the recent 1,700. The Nairobi County ensured that the UHC workers do not get those jobs. Only those under the defunct NMS contract were considered," Wafula noted.
He added that through a letter received from CoG, if counties get budgetary allocation, they shall have to serve another two years at half pay salary without allowances, making it six years of service under such unfair terms and conditions.
"When we held our protest on March 20, 2024, we were informed by the Ministry of Health that CoG has been adamant in engaging us regarding our transition. They failed to attend the meeting that was scheduled by the Ministry of Health on March 8, 2024.
"We do not understand why CoG does not want us to get fair terms despite our immense sacrifice that saved the lives of millions of Kenyans during the pandemic because we have so far not received gratuities for their previous three-year term served that elapsed in 2023. Further, there is no communication from the employer as to when to receive the said gratuities," the National UHC chair said.
He added that despite the issue being gazetted on the gazette notice number 8091 dated October 12, 2020, their employer has not been remitting their National Social Security Fund (NSSF) deductions.
"We now question the urgency of transferring payrolls under unfavourable terms (consolidated salaries) and object to the final deliberations being made and signed solely by the Ministry of Health and the Council of Governors without representation or formal agreement from UHC staff representatives because Panyako does not speak for us on this matter," Wafula said.
However, speaking to Nation in an exclusive interview on Wednesday, CS Duale did not mince his words.
"UHC staffers had leaders and they knew that their leadership was coming to see me. There are a few of them who have not reported to work for over a year now, and we decided to let it go and not punish them. In principle, we have closed that chapter because I have so many other medics to take care of; they are not the only ones," he told Nation.
"These UHC staffers work for and belong to counties, not the Health ministry. The Health ministry was just managing the payroll, but their employer is county governments," CS Duale added.
