Nairobi — A growing dispute over the fate of thousands of Kenya’s frontline health workers has erupted, with a leading union accusing county governments of reneging on a promised employment deal.
The Kenya Environmental Health and Public Health Practitioners Union (KEHPHPU) on Friday criticised remarks by Kakamega Governor Fernandes Baraza, who chairs the Council of Governors’ finance committee, over what he described as a lack of funds to absorb workers hired under the Universal Health Coverage (UHC) programme into permanent roles.
Union leaders say the comments cut deep.
“We view these statements as a mockery of the dedication and sacrifice of UHC healthcare workers,” said Brown Ashira, the union’s secretary general. “These are professionals who have carried the system through some of its most difficult moments.”
At the centre of the dispute is a government pledge affecting 7,414 health workers currently on short-term contracts. Officials had indicated that they would be moved to permanent and pensionable terms, a shift seen by many as long overdue after years of uncertainty.
The Ministry of Health has previously suggested that the transition would be supported through national funding channels, including allocations tied to the Division of Revenue framework. But the Council of Governors has raised concerns about how the money should be managed.
County leaders are pushing for a broader restructuring of UHC funding, arguing that resources should be folded into general county allocations rather than ring-fenced grants. Supporters of the plan say it would give counties greater flexibility in managing their budgets.
Critics, including the union, see it differently.
“They are introducing bureaucratic delays that risk leaving workers without salaries or security,” Mr Ashira said. “We cannot accept that.”
For many of the affected workers, the stakes are personal. Hired during the rollout of the UHC programme and thrust into the spotlight during the Covid-19 pandemic, they have worked for years without long-term guarantees. Delays in gratuity payments and repeated contract extensions have added to the strain.
Health policy analysts note that the standoff reflects a wider tension in Kenya’s devolved system, where responsibility for healthcare delivery lies with counties, while funding decisions are often shaped at the national level.
The union is now escalating its demands. It is calling for the immediate conversion of all UHC contracts into permanent terms, an end to short-term renewals, and swift release of funds to counties to cover the transition.
It has also issued a warning.
“If immediate steps are not taken to honour the agreement, we will paralyse public health services nationwide,” Mr Ashira said.
Officials from the Council of Governors have not issued a detailed public response to the union’s latest statement. But previous remarks suggest counties remain concerned about the long-term financial burden of absorbing the workers without clear, sustained funding from the national government.
At the moment, the impasse leaves thousands of health workers in limbo and raises fresh questions about how Kenya will balance its ambition for universal healthcare with the realities of funding and governance.
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