Thousands of patients across the country were left without medical care as the dispute between county governments and health workers intensified, with both governors and nurses refusing to soften their positions.
As the strike stretched into its third day, public hospitals in many counties operated with little or no services, forcing families to seek treatment in private facilities or return home without help.
The Council of Governors has now threatened to seek legal intervention, arguing that the Kenya National Union of Nurses (KNUN) called the strike even as talks were ongoing. The governors also warned that they would pursue legal guidance on whether the industrial action is lawful.
Mombasa Governor Abdulswamad Nassir, who heads the Council of Governors Health Committee, said the union abandoned negotiations despite discussions having started on key matters affecting health workers, among them the 2025-2029 Collective Bargaining Agreement (CBA).
“The 2017 return-to-work formula was signed by the former Health Cabinet Secretary, and we agreed to start discussions. They also raised the issue of Universal Health Coverage ( UHC) employees, which the national government agreed to continue paying until the Division of Revenue Act is amended,” the governor said.
He said counties are unable to absorb UHC workers on permanent and pensionable terms because there is no guaranteed funding to support such employment.
The nurses' union, however, faulted the governors for waiting until the last minute to begin discussions.
KNUN Assistant Secretary-General Lucy Mburu said the union had already issued a strike notice long before the negotiations resumed, making it impossible to suspend the industrial action.
“A few hours before the strike, they said they were ready to talk, but it was too late. We had issued a strike notice, which they ignored,” she said.
Apart from demanding the implementation of the 2017 return-to-work formula, the union wants enhanced uniform and service allowances fully effected.
The disagreement also touched on career progression for healthcare workers.
Kenya Union of Clinical Officers Secretary-General George Gibore said the courts had already settled the matter by affirming that career guidelines are government policy handled through the Public Service Commission (PSC).
“The court said it does not envisage a situation where every county has its own scheme of service,” he said, adding that the judge quashed governors’ resolutions seeking to invalidate the PSC guidelines.
Nassir rejected that position, insisting county governments remain responsible for setting career guidelines for their own workforce.
“Career guidelines are set by the employer. Counties have agreed to harmonise career guidelines for health workers,” he said.
The prolonged strike has disrupted healthcare services in many parts of the country.
In Mombasa, Coast General Teaching and Referral Hospital suspended new admissions because of the shortage of nurses. Doctors and interns continued attending to outpatients, although many departments operated with limited staff.
In Murang'a County, most public hospitals were either offering minimal services or had completely stopped operations. Patients who sought treatment were advised to return later, while those requiring admission turned to private and mission hospitals.
Hospitals in Meru also started releasing admitted patients earlier in the week as the strike took hold.
In Tharaka Nithi, the County Public Service Board advertised 350 nursing vacancies on six-month renewable contracts in a bid to ease the staffing crisis.
The strike also affected hospitals in Nyandarua, where Nyahururu Referral Hospital remained unusually quiet, with maternity units and wards recording very few patients.
Public health facilities in Narok, Bomet and Kericho experienced similar disruptions, leaving many patients with no option but to leave without treatment.
In Nakuru County, clinical officers stayed away from work while nurses staged a go-slow, affecting service delivery in several hospitals.
Nakuru Health Executive Roselyn Mungai confirmed receiving strike notices from health unions and said the county had put measures in place to reduce the impact on patients.
Hospitals in Nandi, Uasin Gishu, Trans Nzoia and Baringo were also affected after nurses, clinical officers, laboratory technicians and other health workers failed to report to work.
In Trans Nzoia, patients receiving treatment were transferred to private hospitals as public facilities struggled to operate.
Some residents in Uasin Gishu sought treatment from traditional healers, with herbalists reporting increased numbers of people seeking their services in Eldoret.
The effects of the strike were equally evident in Kisumu and Kisii, where outpatient clinics and hospital wards remained almost empty as hundreds of patients searched for alternative healthcare.