Nurses reject payroll shift to counties, vow to strike until pay and job demands met
Health Ministry officials maintain that the payroll transfer is a necessary step for the devolution of health services, as outlined in Kenya's broader healthcare strategy.
Nurses have rejected a proposal by the government to transfer the management of their payroll to county governments, signalling their intent to continue their strike until their demands for improved pay, promotions and better working conditions are addressed.
In a letter sent to Health Cabinet Secretary Aden Duale on May 9, the Kenya National Union of Nurses and Midwives (KNUNM) rejected the government’s recent resolutions communicated on May 6, 2025.
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In the letter, KNUNM General Secretary Seth Panyako stated that the union would not accept the proposed payroll transfer, which would be effective on July 1, unless the government resolves nurses' concerns first.
Panyako also emphasised that the union would not back down from the strike.
“All nurses across the country will join the strike, and they will not stop until their demands are fully addressed,” he stated.
Earlier, Duale had issued a directive asking all nurses involved in the Universal Health Coverage (UHC) programme to return to their duties by May 7.
However, Panyako made it clear that this request would not sway the union.
Rejected in totality
"Following the consultative meeting between the unions and yourselves on May 6, in which both the Principal Secretary and the CEO of the Council of Governors made a communication on the resolutions, our union rejects the contents of the communication in totality," the letter reads.
The proposal to transfer payroll management from the national government to county governments has been part of an ongoing discussion regarding devolution and healthcare staffing.
Under the plan, counties would receive the necessary funding to continue paying UHC staff at current rates during the transition period.
However, the union rejected this approach, citing ongoing issues with discrimination against nurses and their unresolved employment terms.
The government had hoped that shifting payroll responsibilities to the counties would streamline the process of managing UHC staff, but KNUNM insists that the issue is deeper than administrative logistics.
Nurses have expressed dissatisfaction with their treatment compared to doctors under the same programme.
Unfair pay
The union revealed that doctors working under UHC are paid according to the Salaries and Remuneration Commission (SRC) recommended rates, with their full absorption into the healthcare system already included in the national budget.
Despite this, nurses claim they are being paid unfairly and have pointed out the discrimination they face in the healthcare sector.
“We are dissatisfied with how nurses under UHC are treated, especially compared to doctors, who enjoy better pay and employment conditions,” Panyako said.
The Ministry of Health’s announcement on the transfer plan aims to relieve the national government of direct payroll responsibilities for UHC staff, placing it under county jurisdiction starting July 1.
But the union remains steadfast, insisting that the transfer of payroll cannot proceed without ensuring that nurses’ terms of service are regularised and equitable.
Address core issues
"The union has made it clear that we will not accept this transfer unless the government addresses our core issues: fair pay, job security, and recognition of our work," Panyako said.
The union has also claimed that a lack of clear job security and promotion structures for nurses has fuelled dissatisfaction within the profession. Nurses across the country have pledged to stay on strike until these issues are properly addressed.
Health Ministry officials maintain that the payroll transfer is a necessary step for the devolution of health services, as outlined in Kenya's broader healthcare strategy. However, the nurses’ union argues that such a move, without first addressing their concerns, would only worsen the situation.
Nurses have shown no signs of backing down, stating that their strike will continue until the government comes to the table with a fair solution.
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