A fresh nationwide doctors’ strike could be on the cards after the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) accused county governments of delaying the implementation of salary adjustments agreed under the 2017-2021 Collective Bargaining Agreement (CBA).
In a letter dated July 21, 2026, KMPDU Secretary General Dr Davji Atellah said the union had exhausted all administrative, legal and intergovernmental avenues in pursuit of the salary adjustments and payment of accumulated arrears.
The union maintained that counties had failed to implement the agreed salary scales despite repeated engagements involving the Council of Governors (CoG), the Salaries and Remuneration Commission (SRC), the Ministry of Health and the Ministry of Public Service.
“The Union has pursued every administrative, legal and intergovernmental avenue to ensure the adjusted basic salaries are reflected in our members’ payslips and that all outstanding arrears are cleared,” said Dr Atellah in the letter.
Doctors’ Salary Dispute Persists
The dispute stems from the 2017-2021 CBA whose implementation has remained a contentious issue for years, particularly among county-employed doctors.
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The matter formed one of the key grievances during the 56-day nationwide doctors’ strike that ended in May 2024 after KMPDU signed a Return-to-Work Formula (RTWF) with the national government and county governments.
Under the agreement, the governments committed to facilitating payment of salary arrears arising from the CBA and implementing revised salary scales for affected doctors.
The National Treasury was expected to facilitate settlement of county doctors’ arrears through a conditional grant estimated at about Ksh3.5 billion.
According to KMPDU, several milestones have since been achieved to remove obstacles that had delayed implementation.
The union said the Council of Governors formally requested a payroll code for adjusted doctors’ salaries in July 2025 after confirming that resources for payment had been made available.
It further noted that the SRC issued guidance in September 2025 approving the basic salary notches developed for the 2017-2021 cycle, while the Ministry of Public Service later confirmed the availability of a special salary code within the Human Resource Information System (HRIS) to facilitate payments.
KMPDU argued that these developments effectively removed all technical barriers that had been cited by counties as reasons for the delay.
“The budget, the salary structure and the payroll system issues have all been resolved,” the union said in the letter.
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The doctors’ union also pointed to engagements held over the last year, including demands issued to the national government, consultations involving county governments and a recent multi-agency meeting convened by the CoG to discuss implementation across all counties.
Call for Industrial Action
The latest warning follows a resolution passed during KMPDU’s Annual Delegates Conference in May this year.
According to the union, delegates resolved to pursue tougher measures, including contempt of court proceedings and a nationwide strike, should implementation of the salary adjustments continue to stall.
KMPDU said strict deadlines granted by the conference had already lapsed and that doctors should prepare for collective action to compel compliance.
The union insisted there was no longer any justification for further delays, arguing that county governments had already acknowledged the CBA provisions and availability of resources for implementation.
“Compliance will not be delivered on a silver platter; it must be exacted through our collective strength and solidarity,” the letter states.
The renewed standoff threatens to reopen tensions in the health sector barely two years after the country emerged from one of its longest doctors’ strikes.
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