The Kenya Union of Clinical Officers (KUCO) has issued a 21-day strike notice, accusing the Ministry of Health and county governments of failing to honour multiple agreements.
In a letter addressed to the Ministry of Health, Ministry of Labour and the Council of Governors on Tuesday, December 2, the union said the persistent delays have created a crisis that now leaves industrial action as the only remaining option.
KUCO reminded the Council of Governors that a return-to-work deal signed in July 2025, meant to guide implementation timelines, has not been honoured.
"We refer you to the Return to Work Agreement signed between the Union and the Council of County Governments (on behalf of all the 47 Constituent County Governments) dated July, 8, 2025 which provided clear and agreeable terms and timelines for the implementation; which agreement now remains unfulfilled by the Council," the letter read.
KUCO further noted that a separate agreement with the Ministry of Health, signed in July 2024 to conclude the Collective Bargaining Agreement (CBA), has also stalled despite negotiations being completed.
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"On July, 27, 2024, the Ministry of Health and this Union signed a return to work agreement to give effect to the conclusion of CBA negotiations, signing and subsequent Court registrations within sixty days from the date of the said agreement. It is most unfortunate and concerning to us that despite parties having concluded the negotiations, the Ministry of Health is reluctant to the signing of the same so as to pave way for Court registration and implementation," the letter added.
KUCO stated that the government’s failure to finalise and sign the CBA has worsened risks faced by frontline health workers, including exposure to workplace hazards and mental health challenges.
"The failure to conclude and sign the Collective Bargaining Agreement has resulted in significant lapses in addressing various issues, exposing our members to occupational health hazards and mental health challenges," the letter further read.
KUCO also accused several county governments of refusing to implement the Salaries and Remuneration Commission (SRC) pay structure for the current remuneration cycles, including payment of accumulated arrears.
"Additionally, several County Governments have continually refused to implement the SRC reviewed remuneration structure for the 3rd & 4th Cycles and settlement of all accompanying arears," the letter continued.
KUCO went ahead to list four key demands that it insists must be met within the notice period, including immediate signing of the CBA and resumption and conclusion of stalled negotiations.
"In view of the matters mentioned above, the union therefore demands that the Ministry of Health to immediately set and communicate a date for the signing of the concluded Collective Bargaining Agreement; the Council of Governors to immediately set and communicate a date for the resumption of the CBA negotiations and conclude within 21 days; immediate implementation of the SRC reviewed remuneration structure for the 3rd & 4th Cycles and settlement of all accompanying arears by the County Governments; and he Council of Governors to immediately absorb all Global Fund and UHC Staff," the union demanded.
KUCO warned that the government’s continued inaction has destroyed trust built through previous negotiations, leaving the union with no alternative but to call for nationwide industrial action.
"This act not only undermines the spirit of dialogue and mutual respect but also erodes the trust we have tried to build through the negotiation process. It is in this regard that we are now left with no option but to issue this twenty one (21) days strike notice with effect from the date of this letter," the letter read.
KUCO warned that all clinical officers will withdraw their services starting December 22 if the listed demands are not met.
"Should the Ministry of Health and the County Governments fail to satisfactorily address these issues during the intervening period, commence implementation of the said agreements, all our members shall withdraw their services and commence industrial action without further notice effective Monday, December 22, 2025 midnight and shall continue until an settlement agreement is fully signed, executed, and implemented," the letter concluded.
This comes weeks after a five-month doctors’ strike in Kiambu County ended following a breakthrough agreement between the Kenya Medical Practitioners, Pharmacists, and Dentists Union (KMPDU) and the county government.
The deal was reached after a mediation process led by the Council of Governors (COG), which relieved thousands of residents who had endured months without adequate public healthcare services.
Speaking to the press, the COG Whip and Tharaka Nithi Governor Muthomi Njuki, who chaired the meeting, confirmed that both parties had agreed to a settlement that would see doctors resume work starting Monday next week.
Under the agreement, the county government committed to paying one month’s salary for the strike period and immediately releasing October salaries.
Njuki urged both sides to maintain open dialogue in the future, emphasizing the need for cooperation over confrontation.
"We call upon the county government and the union to embrace dialogue to ensure that the contentious issues are resolved as soon as possible so that service delivery in the health sector is uninterrupted," he said.
KMPDU Secretary General Davji Atellah confirmed the end of the more than 150-day strike that began on May 26, 2025.
"The strike that began on the 26th of May 2025 is hereby called off. I’m aware not all doctors are within their workstations, so we are asking them to start traveling back and resume duties on Monday," he announced.
