Nairobi-Kenyan governors are pushing back against a national plan to shift thousands of healthcare workers from central government control to the counties without the money to pay them.
In a tense standoff that could disrupt health services across the country, the Council of Governors (CoG) has asked President William Ruto to convene an urgent meeting to resolve what it calls a mishandled transition under the Universal Health Coverage (UHC) programme.
“We will not accept this burden unless it comes with the money to match,” said Wajir Governor Ahmed Abdullahi, who chairs the CoG. “No payroll has officially been handed over, and we won’t absorb it blindly.”
The row centres on more than 9,000 healthcare workers hired under the UHC programme during the COVID-19 pandemic. These workers, who have been on short-term contracts for up to six years, have been demanding full employment and payment of promised gratuities.
Now, with the Ministry of Health moving the UHC payroll to county governments effective 1 July, the governors say the shift has been forced on them without proper consultation or funding.
A Brewing Labour Dispute
The healthcare workers have held repeated protests outside the Ministry of Health and Parliament, calling for job security or compensation before being redeployed under new terms. Many say they were promised permanent roles, but years later, those promises remain unfulfilled.
“We served this country through a pandemic,” one protester said during a recent demonstration in Nairobi. “Now they want to dump us without pay or jobs.”
At the heart of the dispute is funding. County bosses say they have not received the necessary allocations to cover the workers’ salaries, benefits, or end-of-contract payments.
“The process is being rushed and mismanaged,” Governor Abdullahi said. “Health Cabinet Secretary Aden Duale is pushing counties to take on a payroll without funding or proper planning.”
Mixed Messages from Nairobi
Over the weekend, Duale acknowledged the ministry’s budget shortfall.
“We do not have the money to absorb all UHC staff under the ministry,” he said, signaling that the transfer to counties is not just policy it’s also financial necessity.
But county leaders argue they are being asked to clean up a mess they did not create.
“We can’t be dragged into a crisis that hasn’t been resolved,” said Tharaka Nithi Governor Muthomi Njuki, who chairs the CoG Health Committee. “Let the national government first settle the outstanding issues then talk to us.”
What’s Next?
The deadlock raises real concerns about service delivery. If counties refuse to take on UHC workers and the national government steps back, thousands of health workers could be left in limbo and ordinary Kenyans could pay the price.
The governors have not ruled out escalating the matter politically, and some have hinted that health services could be disrupted if the impasse continues into July.
As pressure mounts, all eyes are now on State House. The governors want a sit-down with President Ruto before any handover takes effect. Without it, Kenya’s ambitious push for universal healthcare may stumble again under the weight of poor coordination and a strained public purse.
