Counties push for Sh7.8 billion funding to permanently absorb 8,000 UHC workers

Counties say they need at least Sh7.8 billion every financial year to absorb more than 8,000 Universal Health Coverage (UHC) staff into their payrolls.

Speaking on Sunday in an interview with Citizen TV, Council of Governors (CoG) Health Committee Chairperson Muthomi Njuki said the funding is essential for counties to manage the new workforce without straining their budgets.

“We will require Sh7.8 billion every financial year, without putting into consideration the CBA and also other yearly promotions, because every year there is a yearly increment,” Njuki said.

“The county should be able to take care of that when they have these other resources. Without this funding, we risk transferring the strike issues from the Ministry of Health to the 47 county headquarters, and it is going to be very sad. That is why we need to agree with the ministry.”

Njuki, who also chairs the CoG Health Committee, noted that of the 9,724 staff recruited, only 100 have been absorbed by the Ministry of Health (MoH), leaving 7,476 under county oversight. He stressed that counties are willing to employ them on permanent and pensionable terms, but this requires guaranteed resources.

“We are supporting their absorption on permanent, pensionable terms, but not just for the remaining 10 months of the contract. We would like it to be in perpetuity. Without the resources to absorb them long-term, this will be a problem,” Njuki said.

He explained that the national government has already allocated Sh6.2 billion for absorption, with about Sh700 million spent on July and August salaries.

“The remaining Sh5.4 billion may cover the next 10 months, but beyond that, counties need additional resources,” he said.

Stalled procurement

Njuki also raised concerns over stalled procurement in the first quarter, which he said has paralysed essential government operations.

“Counties have not done a single procurement this first quarter, and it’s impossible to run government for three months without fresh procurement. Medicines, fuel, and development projects all need to be procured in the first quarter. Yet the e-procurement system is not ready, and we have to decide whether to wait for it or use existing systems,” he said.

On the process of permanent absorption, he clarified that counties must issue formal appointment letters.

“First and foremost, absorption is not just paying the market rate. A letter terminating the old contract and specifying new terms must be given. The ministry cannot do that alone because they did not issue the original appointment letters,” Njuki said.

He emphasised the need for clear coordination between counties and the MoH.

“Health is devolved. There is no necessity for a pseudo arrangement where the staff are with counties, but payroll is with MoH. This has caused problems, especially when staff leave, as payroll continues for years even after staff exit,” he said.

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No extra money

Responding to claims by the Kenya National Union of Nurses that resources should follow functions, Njuki remarked, “If resources had followed functions in 2020, we wouldn’t be in this position. Since 2023, counties have not been given extra money to absorb the staff. The payroll should come to counties with the requisite resources to absorb them permanently and pensionably.”

He also pointed out contractual obligations for gratuity payments to staff who have already served under UHC.

“The MoH cannot transfer staff to counties without paying gratuity and pension. This is separate from the Sh7.8 billion annual funding, which is for salaries. Gratuity is a one-off payment for years already served,” he said.

Despite the challenges, Njuki praised UHC staff for their service under tough conditions.

“If I were in charge of giving medals, I would give them to the UHC staff. They have worked under difficult conditions since Covid, on contracts below market rate. Diploma holders earned Sh50,000, certificate holders Sh40,000, with no benefits or promotions. This is almost half of what their colleagues earn,” he said.