Kenya’s public hospitals are facing a deepening crisis as a nationwide nurses’ strike enters its sixth week, leaving patients with limited access to care and raising fresh concerns about deaths in maternity and newborn units.
The strike began on July 29 after the Kenya National Union of Nurses and Midwives (KNUNM) failed to reach agreement with county governments over employment terms, pay and the implementation of past agreements.
By Thursday, the dispute had entered its 37th day.
Health professionals say the prolonged disruption is taking a growing toll. The National Nurses Association of Kenya reported that eight maternal deaths, 16 neonatal deaths and 55 perinatal deaths were recorded nationally between Monday and Wednesday this week.
The figures have intensified calls for the government, county authorities and the nurses’ union to find a way out of the dispute.
Collins Otieno Ajwang, chairman of the National Nurses Association of Kenya, said the continuing strike was placing an increasing burden on an already strained public health system.
“The concern as fellow health professionals is what this continuing delay is now costing patients and the healthcare system,” he said.
The dispute centres on collective bargaining agreements that nurses say have remained unresolved for years. The union is demanding action on the 2017 Return-to-Work Formula, the conclusion of the 2025–2029 Collective Bargaining Agreement and the implementation of career progression guidelines.
It is also seeking permanent and pensionable terms for workers employed under the Universal Health Coverage programme.
Some progress has been reported. The national and county governments have agreed on the absorption of UHC workers into permanent and pensionable employment, while discussions on career progression guidelines have also moved forward.
But the central disagreement over the CBA remains.
KNUN Secretary-General Seth Panyako said the union would not call off the strike without a formal agreement.
“The main elephant in the house is the issue of the collective bargaining agreement,” Mr Panyako said on Tuesday. “We do not have a deal yet.”
County governments have taken a different position. Council of Governors chairman Ahmed Abdullahi has urged nurses to return to work while negotiations continue.
Abdullahi has argued that the 2017 agreement was signed under difficult circumstances and that counties cannot commit to obligations they say they cannot afford. The Council of Governors has also maintained that the strike should end as talks proceed.
The disagreement has left thousands of patients navigating an increasingly difficult health system.
Public hospitals in several counties have reported reduced services, with some patients being directed to private facilities or neighbouring counties. In Trans Nzoia, however, nurses returned to work this week after 42 days following a county-level return-to-work agreement.
The Kenya Medical Association has called for urgent dialogue, warning that the dispute is affecting vulnerable patients and exposing deeper weaknesses in the way labour disagreements in the health sector are handled.
The association has argued that both health workers and patients have rights that must be protected, including workers’ right to fair labour practices and Kenyans’ right to the highest attainable standard of health.
For patients waiting in public hospitals, however, the debate over contracts and finances offers little immediate relief. The longer the dispute continues, the greater the pressure on a system already struggling to provide care.
The government and the unions now face a choice that is becoming harder to postpone: return to the negotiating table with a settlement, or allow a labour dispute to further widen a public health crisis.
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