The Health Union Caucus, a coalition of Kenya’s leading healthcare unions, has issued a 7-day ultimatum to the Ministry of Health, the Council of Governors, and other relevant authorities, demanding urgent action on unresolved issues affecting health workers across the country.
The ultimatum highlights systemic failures in the absorption of Universal Health Coverage (UHC) contract staff, persistent salary delays, and deteriorating working conditions, particularly in Kiambu County.
In a statement dated September 30, 2025, the unions warn that failure to meet their demands will trigger nationwide industrial action, threatening to paralyze public health services.
Delayed Absorption of UHC Staff
At the centre of the dispute is the prolonged delay in absorbing over 8,000 UHC contract workers into permanent and pensionable terms.
The unions demand the immediate absorption of healthcare workers employed under the Universal Health Coverage (UHC), Global Fund, and Community Health Promoters (CHERP) programs into permanent and pensionable terms, with back pay effective July 1, 2023.
Despite a Ksh6.2 billion allocation by Parliament and resolutions from multi-stakeholder engagements involving the Ministry of Health and the Council of Governors, implementation has stalled since July 1, 2025.
The unions accuse the government of betraying frontline workers who played a critical role in rolling out UHC programs.
Bureaucratic hurdles have affected verification exercises and payroll transfers, leaving thousands of health workers in financial limbo.
The result has been widespread demotivation, burnout, and service disruptions.
Kiambu County in Crisis
Kiambu County has emerged as the epicenter of the crisis.
Healthcare workers there have endured delayed salaries, stalled promotions, and unilateral termination of union deductions.
The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) reports that the county has failed to honour court orders and collective bargaining agreements, leading to a prolonged doctors’ strike and the redeployment of nearly 700 medical interns.
Despite claims by Kiambu officials that salaries are being processed and promotions have been made, union data shows consistent delays in salary payments that have been ongoing for over a year.
The county’s decision to switch medical cover from NHIF to MUA Insurance has also sparked protests, with workers citing reduced benefits and lack of consultation.
National Salary Delays
Fiscal constraints, debt servicing pressures, and a freeze on salary reviews by the Salaries and Remuneration Commission (SRC) have left civil servants, including health workers, struggling to make ends meet.
The unions have cautiously welcomed the Quality of Healthcare and Patient Safety Bill 2025, which aims to regulate facilities and enforce standards.
However, they warn that the bill risks duplicating existing regulatory bodies and imposing punitive measures on under-resourced facilities.
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Only 5.8% of health facilities currently have accident and emergency units, signalling the need for investment in infrastructure and workforce training.
Key Demands from the Health Union Caucus
The unions are calling for:
- Immediate absorption of all healthcare workers under the UHC, Global Fund, and CHERP programs into permanent and pensionable terms, with full back pay by the respective county governments.
- Full implementation of the SRC-reviewed remuneration structure across all counties.
- Payment of all withheld salaries and remittance of statutory and third-party deductions in Kiambu County.
- Regularization of punitive, exploitative, and irregular contracts issued by county governments.
- Centralized negotiation of Collective Bargaining Agreements (CBAs) to ensure uniformity and fairness.
- Parliamentary investigations by the National Assembly and Senate into the mistreatment of healthcare workers in Kiambu County.
- Immediate reinstatement of union deductions and signing of a non-victimization clause in Kiambu County.
The unions warn that Kiambu County has adopted a “labour lockout” approach, refusing to engage with unions despite valid grievances.
“We will not stand by as our members are mistreated, underpaid, and silenced. The time for action is now.”
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The unions insist that the government must act decisively to protect the integrity of the healthcare system and the welfare of its workforce.
Unions Represented in the Health Union Caucus
Kenya Union of Clinical Officers (KUCO)
- Signed by: George M. Gibore, General Secretary
Kenya Medical Practitioners, Pharmacists, and Dentists Union (KMPDU)
- Signed by: Dr. Davji Atellah, General Secretary
Kenya Environmental Health and Public Health Union (KEPHHU)
- Signed by: Bonyo Ashira, General Secretary
Kenya National Union of Medical Laboratory Officers (KNUMLO)
- Signed by: Nyakundi Moriasi Pius, General Secretary
Kenya Union of Nutritionists and Dieticians (KUNAD)
- Signed by: Michael Ouma Odero, General Secretary
Kenya National Union of Pharmaceutical Technologists (KNUPT)
- Signed by: Mutuma E. Irura, General Secretary
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