Kenya’s healthcare system is facing an escalating crisis as nurses from Machakos, Siaya, and Kisii counties have joined an expanding wave of industrial action, crippling services in public hospitals.
The walkouts, led by the Kenya National Union of Nurses and Midwives, stem from long-standing disputes over unfulfilled agreements, delayed promotions, and poor working conditions.
In Machakos, striking nurses accuse the county government of flouting the Salaries and Remuneration Commission’s (SRC) salary review structure despite a national directive issued in September 2024 to harmonize pay.
They argue that the county has failed to honor a return-to-work agreement, forcing them to halt services in all public hospitals until their demands, including promised promotions and salary adjustments, are met.
In Siaya, union leaders say negotiations have stalled despite two formal meetings at the Ministry of Labour.
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The county, they claim, has dismissed their grievances, ranging from allowances to staffing shortages, as matters only the Council of Governors and SRC can address.
After a 30-day negotiation window expired without resolution, nurses downed tools, demanding a KSh15,000 uniform allowance increment, a KSh10,000 nursing allowance, improved risk pay, and the permanent absorption of nurses hired on contract during the COVID-19 pandemic.
Kisii nurses have raised similar complaints, accusing their employer of failing to implement the collective bargaining agreement, failing to remit statutory deductions on time, and ignoring repeated calls to address unsafe workloads.
The standoff among nurses coincides with fresh threats from the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU), which has issued a 14-day strike notice over what it describes as the government’s blatant disregard for legally binding agreements.
In a strongly worded letter dated August 8, KMPDU Secretary General Dr. Davji Atellah accused national and county governments of reneging on the 2017–2021 Collective Bargaining Agreement and subsequent amendments.
The union cites failure to release conditional grants to counties, delays in salary adjustments, and non-payment of arrears agreed in the May 8, 2024, Return-to-Work Formula and its December 19 addendum.
Dr. Atellah warned that doctors' July 2025 payslips did not reflect the agreed salary adjustments, calling this a breach of contract and a betrayal of trust.
He further cautioned that unless the matter is resolved within the notice period, doctors nationwide, including those at Kenyatta National Hospital, Moi Teaching and Referral Hospital, and county hospitals, could leave the job, potentially grinding public healthcare to a halt.
"Take notice that unless the issues herein are resolved within 14 days, the highest decision-making organ of the union will convene to determine the way forward, including but not limited to calling for industrial action," Dr. Atellah stated.
