Clinical officers are still being pushed into strikes months after a national agreement was reached, with the Kenya Union of Clinical Officers (KUCO) blaming county governments for failing to fully implement negotiated employment terms.
KUCO Deputy Secretary General Austin Otieno Oduor says unfulfilled agreements remain the main reason clinical officers continue to take industrial action, with differences between counties creating unequal working conditions for health workers.
Speaking during a Radio Generation interview on Wednesday, Oduor said clinical officers in Nairobi had spent nearly 180 days on strike over agreements that had not been honoured.
“The core of the strike is, I can say, agreements that have never been fulfilled, or you have an agreement, but the implementation becomes a nightmare. The same is happening with the Kenya Union of Clinical Officers and the Kenya Union of Nurses. The main thing there is unfulfillment of the agreements, because we've had several agreements,” he said.
The dispute comes after KUCO and county governments signed a national Collective Bargaining Agreement (CBA) on February 2, 2026, following nearly eight years of negotiations.
The agreement came after a 36-day nationwide strike that began on December 23, 2025. However, its signing has not brought an end to disagreements over implementation, with counties moving at different speeds in adopting the agreed terms.
KUCO chairman Peterson Wachira said only four counties had fully signed the agreement during the initial ceremony. About 16 agreements were later submitted to the Salaries and Remuneration Commission (SRC), while other counties were still awaiting the required approvals.
Among the issues causing friction are risk allowances, promotions, career progression and employment terms.
The health risk allowance has been a major sticking point. Clinical officers had previously been paid Sh3,000 per month, while the negotiated terms provided for an increase.
Health Cabinet Secretary Aden Duale said in January that the allowance had been raised to Sh7,000. The return-to-work agreement, however, provided for Sh5,000 in the 2025/26 financial year, including arrears from July 2025, before increasing to Sh7,000 from July 2026.
Oduor said the union had initially sought Sh15,000 before settling for a lower figure during negotiations.
“We negotiated the allowance down to Sh7,000. The amount had to go through the approval process, with SRC seeking clearance from the National Treasury. Treasury approved the amount, and SRC subsequently issued a letter of no objection,” he said.
The unresolved issues have continued to trigger county-level strikes. In Siaya, clinical officers ended a 21-day strike in June after reaching an agreement covering CBA implementation, risk allowance and arrears, promotions and career guidelines.
In Kericho, workers called off a month-long strike in July after the county signed a CBA with KUCO, becoming one of the first 20 counties to conclude the agreement at county level.
KUCO also issued a 14-day nationwide strike notice in July, citing delays by counties in signing the CBA, failure to implement the January 2026 return-to-work formula, risk allowance disputes and delays in applying career guidelines.
In West Pokot, clinical officers ended a 48-day strike on September 8 after signing a return-to-work agreement addressing CBA implementation, risk allowances, career progression and permanent-and-pensionable employment for UHC workers.
Oduor says devolution has made the problem harder because health workers are employed and managed separately by the 47 county governments.
He wants a central health service commission established to oversee health workers and ensure uniform employment conditions, promotions and implementation of negotiated agreements.
“If you have a health service commission, this strike would have ended. Why? If we had a health service commission or a central body, and we had agreed, the matters can be sorted out within a day,” he said.
The eight-year CBA negotiations have therefore given way to a new battle over implementation, with county-level disputes continuing to keep clinical officers on strike despite the national agreement.