The Kenya nurses strike has intensified a wider dispute over healthcare financing, workers’ rights and the implementation of collective bargaining agreements, with activist Davies Okombo questioning the Council of Governors’ claim that a key 2017 agreement was signed under duress.
Okombo said the legality of the agreement should be determined by a court rather than by the Council of Governors (CoG), as the nationwide nurses’ strike continues to disrupt services in public health facilities.
His comments came after CoG Chairperson Ahmed Abdullahi urged nurses to return to work and said counties would continue negotiations over their grievances.
Abdullahi said the dispute centred on a Collective Bargaining Agreement (CBA) negotiated around the 2017 General Election, which he said was signed under duress, had never been fully implemented and was financially unsustainable. The CoG has also maintained that the strike is illegal and directed county public service boards to deal with workers who have defied court orders to resume duty.
The nurses’ strike began on July 29 and has affected health services in counties across the country. Their demands include implementation of the 2017 return-to-work formula, conclusion of the current CBA, career progression guidelines and permanent and pensionable terms for Universal Health Coverage workers.
Kenya nurses strike puts 2017 CBA under scrutiny
Okombo challenged the governors’ argument that the 2017 CBA was signed under pressure, saying the courts should determine whether there was duress and what remedy, if any, should follow.
“It is only the courts of law that can determine if a contract is signed under pressure and therefore can prescribe any remedy for that matter,” he said.
His intervention places the legality of the agreement at the centre of the nurses’ strike, which has continued despite calls by county governments for health workers to return to their stations.
Okombo said the dispute should also be understood within the broader problems affecting Kenya’s health system.
“The healthcare crisis is a really growing concern in Kenya, right from the health financing model that we have,” he said.
The CoG has said it wants negotiations to continue and has proposed engaging the Salaries and Remuneration Commission (SRC) on the financial implications of the disputed agreement. Abdullahi said counties had offered to negotiate with nurses but wanted the health workers to resume duty as talks continued.
Nurses strike exposes healthcare funding gaps
Okombo argued that the dispute over health workers’ pay is inseparable from the broader question of how Kenya finances its healthcare system.
He said inadequate resources affect the ability of governments to fund health workers, medical supplies and other essential services.
“What we have seen in Kenya is less than 7% and that means that we lack enough resources that can be able to finance healthcare, which includes medical supplies, the healthcare workers, and so on,” Okombo said.
The figure is Okombo’s assessment rather than an independently established statistic in the material provided. Kenya’s health financing remains under pressure as the government implements the Social Health Authority (SHA) and seeks to expand domestic financing. An analysis of the 2026/27 budget said health allocations were equivalent to about 3.6% of total government expenditure and 1.3% of GDP.
Okombo referred to the Abuja Declaration, under which African governments committed to a target of allocating at least 15 per cent of government expenditure to health.
The benchmark has remained difficult for many African countries to achieve. Recent analysis found that only one African country met the 15 per cent benchmark in 2022, while most remained below 10 per cent.
For Kenya, the financing debate has become particularly important as counties face competing demands for health workers, medicines and other public services.
Kenya nurses strike tests UHC promise
Okombo also questioned whether Kenya can achieve universal health coverage (UHC) while patients continue to experience disruptions in public healthcare.
“Where is the promise on universal health coverage and the Constitution’s promise on access to affordable, quality healthcare when we see health workers on the streets, Kenyans unable to access healthcare?” he asked.
Article 43 of the Constitution guarantees every person the right to the highest attainable standard of health, including healthcare services and reproductive healthcare.
Okombo said the continuing disruption raised questions about whether governments were meeting that constitutional obligation.
“In my view, and I agree with you that the state has failed to deliver adequate and reasonable healthcare to the people of Kenya,” he said.
His criticism targets both levels of government, as health is a devolved function while national government institutions remain responsible for broader health policy and financing arrangements.
CoG seeks talks as nurses remain on strike
The Council of Governors has maintained that the solution lies in negotiations rather than continued industrial action.
Abdullahi said governors wanted nurses to return to work while talks continued and indicated that counties could engage SRC on the financial implications of any agreement reached.
The CoG has also left individual governors and county public service boards to determine how to handle nurses who remain away from work despite court orders, raising the prospect of disciplinary action against some health workers.
The dispute has therefore moved beyond the implementation of a nine-year-old agreement. It now touches on the limits of county finances, the enforcement of court orders, health workers’ employment rights and the government’s promise to provide accessible healthcare.
For patients who depend on county hospitals and health centres, however, the immediate issue remains whether the two sides can reach an agreement that ends the Kenya nurses strike without leaving the underlying CBA dispute unresolved.
