MOMBASA, Kenya — The voice from Kenya’s frontlines of healthcare is getting sharper. And louder.
This past weekend, the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) drew a red line—naming and shaming county governments that, in its view, have let down the country’s doctors.
Eighteen counties are in the crosshairs. If action isn’t taken soon, the union warns, health services in those regions may grind to a halt.
“We’re giving the Cabinet Secretary two weeks,” said Dr. Davji Atellah, KMPDU’s Secretary General, speaking during the union’s annual conference in Mombasa. “After that, we’ll issue strike notices.”
The issue at the heart of the standoff? Delayed remittance of medical insurance contributions—money deducted from doctors’ pay but not passed on to the Social Health Authority. The result: doctors themselves can’t access medical care.
“Doctors in counties such as Kiambu are unable to get the services they provide to others,” said Dr. Atellah, visibly frustrated. “We’ve tried to engage the Kiambu leadership. They’ve gone silent. What are we left with?”
He paused, looked directly at Cabinet Secretary for Health Aden Duale—present at the event, marking the first time a Health CS has attended the KMPDU conference—and added, “This won’t be a governor’s issue anymore. It’s now on your desk.”
A Line in the Sand
The threat of strikes isn’t empty talk. KMPDU’s National Executive Council has already approved industrial action in all 18 affected counties, including Kakamega, Marsabit, Lamu and Kiambu.
But out of respect for Duale’s presence, Atellah said, the union would delay issuing the formal notices—just for now.
Behind the scenes, frustrations have been brewing for months. Doctors say they’ve been stretched to their limits, battling poor working conditions, lack of equipment, and salary delays. And when they fall ill, some can’t even use their own health coverage.
Is Devolution Failing Healthcare?
Dr. Dennis Miskellah, KMPDU’s Deputy Secretary General, went a step further—calling for a deeper rethink.
“Maybe it’s time we admit counties can’t manage health,” he said bluntly. “Let healthcare go back to the national government. Let’s establish a Health Service Commission and end this circus.”
His comments reflect growing discontent with the 2013 devolution of healthcare services—a move meant to bring medical care closer to communities, but which has often been marred by bureaucratic delays and uneven management.
The CS Responds
Health Cabinet Secretary Duale acknowledged the doctors’ complaints and promised swift action.
“Give me the list of those counties,” he told the union. “I’ll engage their leadership directly. We need to sort this out quickly.”
But whether that will be enough remains to be seen. For many doctors, it’s no longer just about delayed payments—it’s about trust. And that trust, they say, is wearing thin.
An Escalating Crisis
This isn’t the first time Kenya’s medical sector has teetered on the edge. From nationwide strikes to court battles over working conditions, the tension between medics and the state is nothing new.
But this time, the tone feels different. The union isn’t only warning about strikes—it’s questioning the entire system.
“This is not about money anymore,” said one doctor at the sidelines of the conference. “It’s about dignity. We’re being pushed out of the very system we’ve given our lives to serve.”
Whether Kenya’s top health officials can mend the rift—or whether the crisis will deepen in the coming weeks—now hangs in the balance.
For now, the doctors are waiting. But not for long.
