For five weeks, Kenya's public hospitals have operated in the shadow of an unresolved promise — nurses who once accepted a handshake in 2017 and watched it dissolve into inaction are now refusing to move until ink meets paper and implementation follows. The Kenya National Union of Nurses and Midwives, representing workers whose labor underpins the nation's health system, has drawn a clear philosophical boundary: dialogue without consequence is not dialogue at all. Across counties, patients wait, and the government faces a reckoning with the cost of deferred accountability.
Kenyan nurses set implementation demands before ending five-week strike
Patients across Kenya face delayed treatment and limited access to healthcare services due to the nationwide nurses' strike affecting public health facilities.
They had been down that road before—promises without implementation.
Mark
So the nurses have been out for five weeks now. Why haven't they just come back to the table and settled this?
Mimi
They say they are at the table. The union is actively meeting with governors and the government. But they're not willing to accept promises anymore—they want signed agreements and actual implementation.
Luke
That's fair, but we should be clear: the source doesn't tell us exactly what "implementation" looks like or how long it would take. The union wants the CBA approved by the Salaries and Remuneration Commission, but we don't know how quickly that body moves.
Mark
What's the CBA, and why is it such a sticking point?
Mimi
It's a Collective Bargaining Agreement—basically the contract that sets out wages, benefits, and working conditions for nurses. The union says it has to be concluded and approved before they'll go back.
Luke
Right, but the source doesn't actually tell us what's in dispute within the CBA negotiations. We know it's the biggest hurdle, but we don't know if it's about salary, hours, staffing levels, or something else entirely.
Mark
What about the UHC workers the union keeps mentioning?
Mimi
Those are people hired under the Universal Health Coverage program. The union wants them to have permanent, pensionable jobs—stable employment with pension benefits. Right now they're in a kind of limbo.
Luke
The government did issue a directive to address their payroll and HR issues, so there's movement there. But again, the source doesn't tell us whether that directive actually solves the problem or just promises to look at it.
Mark
And the 2017 agreement that keeps coming up?
Mimi
The union signed a return-to-work deal back then to end a previous strike, but they say key parts were never implemented. So they're skeptical of promises now.
Luke
That's important context, but we should note: the source doesn't specify which parts of the 2017 agreement were left undone. That's a gap in what we know.
Mark
What happens if this doesn't get resolved soon?
Mimi
The union has threatened to extend the strike to national referral facilities—the big teaching hospitals. Right now it's mainly affecting county-level public health services.
Luke
And patients are the ones caught in the middle—delayed treatment, limited access to care. The source is clear on that impact, even if we don't have specific numbers on how many people have been affected.
The Pulse
- Five weeks of industrial action have left public hospitals understaffed nationwide, with patients facing delayed treatment and diminished access to care in counties across Kenya.
- The union's refusal to accept verbal assurances is rooted in lived experience — a 2017 return-to-work agreement was signed and then quietly abandoned, and nurses are determined not to repeat that betrayal.
- The Collective Bargaining Agreement remains the immovable sticking point, with the union demanding it be formally submitted to the Salaries and Remuneration Commission and a no-objection letter issued before any nurse returns to duty.
- Mombasa's governor moving to hire 573 contract nurses has sharpened tensions, with the union reading the recruitment as a deliberate attempt to erode their bargaining power rather than a genuine solution.
- The union has issued a seven-day ultimatum to the Salaries and Remuneration Commission and threatened to extend the strike to national referral hospitals if demands remain unmet, raising the stakes for the entire health system.
For five weeks, Kenya's public hospitals have operated in the shadow of an unresolved promise — nurses who once accepted a handshake in 2017 and watched it dissolve into inaction are now refusing to move until ink meets paper and implementation follows. The Kenya National Union of Nurses and Midwives, representing workers whose labor underpins the nation's health system, has drawn a clear philosophical boundary: dialogue without consequence is not dialogue at all. Across counties, patients wait, and the government faces a reckoning with the cost of deferred accountability.
Five weeks after the Kenya National Union of Nurses and Midwives launched its nationwide strike on July 29, public hospitals remain understaffed and patients across the country continue to face delays in treatment. The union's leadership, led by Secretary General Seth Panyako, has been unambiguous: they are willing to negotiate, but they will not return to work on the strength of promises alone.
The union's demands span four interconnected issues — full implementation of a 2017 return-to-work agreement that was signed but never honored, conclusion of a new Collective Bargaining Agreement, adoption of career progression guidelines, and permanent pensionable status for nurses employed under the Universal Health Coverage program. Each demand touches something fundamental: pay, job security, and the basic dignity of professional terms.
Some progress has emerged. The Council of Governors' Health Committee, chaired by Mombasa Governor Abdulswamad Nassir, tentatively agreed to form a committee on career progression guidelines, and the government issued a directive on payroll issues for UHC workers. But the CBA remains unresolved, and Panyako has made clear that without a formal no-objection letter from the Salaries and Remuneration Commission, there will be no resumption of duty. He gave the commission a seven-day ultimatum.
The union is also navigating internal pressure. Some branch officials reportedly told local nurses the strike had ended — a claim the national leadership swiftly denied, reminding members that only the union's central leadership holds the authority to call off the action. Meanwhile, Nassir's decision to recruit 573 contract nurses in Mombasa drew sharp criticism from the union, which saw the move as an attempt to weaken their position rather than address the underlying grievances.
With a threat to expand the strike to national referral facilities still on the table, the standoff has entered a critical phase. The union has framed its position not as obstruction but as a hard-won lesson: in 2017, words were enough to end a strike, and those words were forgotten. This time, they are waiting for something that cannot be quietly shelved.
Five weeks into a nationwide strike that has left public hospitals understaffed and patients waiting for care across Kenya, the nurses' union is drawing a line: they will return to work, but only after the government and county governors sign off on their demands and actually implement them.
The Kenya National Union of Nurses and Midwives began their industrial action on July 29, and as August neared its end, the disruption had spread through health facilities in counties across the country. Patients faced delays in treatment and struggled to access services. But the union's leadership, led by Secretary General Seth Panyako, made clear they were not interested in vague promises or handshake agreements. They had been down that road before.
The union's core demands centered on four areas: implementation of a return-to-work agreement signed in 2017 that they say was never fully honored; conclusion and approval of a new Collective Bargaining Agreement, or CBA; adoption of career progression guidelines for nurses; and permanent, pensionable employment status for workers hired under the Universal Health Coverage program. They also wanted outstanding county-level agreements resolved and other employment grievances addressed. These were not abstract complaints—they touched on pay, job security, and the basic terms under which nurses worked.
Recent negotiations had produced some movement. The union and the Council of Governors' Health Committee, chaired by Mombasa Governor Abdulswamad Nassir, had tentatively agreed to establish a committee to review and develop career progression guidelines. On the UHC workers, the government had issued a directive to address payroll and human resources issues, and Panyako said he expected the President's word to be honored. But the biggest obstacle remained the CBA. The union insisted it had to be concluded and sent to the Salaries and Remuneration Commission for formal approval before nurses could resume duty. Without that letter of no objection, Panyako said, there would be no return.
Meanwhile, some governors were moving ahead with recruitment. Nassir had ordered the immediate hiring of 573 nurses on contract terms in Mombasa, arguing there was no shortage and that over 1,000 people would apply if positions were advertised. The union's Maurice Odhiambo questioned the timing: if money was suddenly available for new hires, why had longstanding grievances gone unresolved? The message was pointed—the union saw the recruitment as an attempt to undermine their leverage.
The union was also managing internal discipline. Some branch officials had reportedly told nurses in their areas that the strike had ended, but the national leadership made clear that only they could call off the action. Odhiambo urged nurses to remain firm and reassured the public that the strike would continue until governors and the commission acted. The union had even threatened to expand the strike to national referral facilities if a settlement was not reached.
Panyako had given the Salaries and Remuneration Commission a seven-day ultimatum to issue the no-objection letters. The union framed their position as a commitment to dialogue—they were ready to negotiate, they said, but negotiation meant something concrete. It meant signed agreements, official approvals, and actual implementation. They had learned from 2017 that words alone were not enough. For now, the strike continued, and public health services remained disrupted. The question was whether the government and governors would move fast enough to satisfy the union's demands, or whether the standoff would deepen.
Notable Quotes
We are committed to multi-level diplomacy and we aggressively continue to pursue structured engagements at both the county and national levels to address labour grievances and restore normalcy in our health facilities.— Seth Panyako, KNUNM Secretary General
The nurses will not go back to work until we have the CBA, until we have the UHC staff getting their letters of permanent and pensionable employment and paid gratuity, until our career progression guidelines are implemented.— Maurice Odhiambo, union official
Want the full story?
Read the original at the-star.co.ke ↗
Politics & Governance