Doctors Issue Two-Week Strike Notice in Four Kenyan Counties Over Unfulfilled Agreements
The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) has issued a two-week strike notice for doctors in Kajiado, Kilifi, Nakuru, and Embu counties. The strike threat arises from the failure of these counties to honor collective bargaining agreements regarding promotions, salary increments, and improved working conditions. The article provides comprehensive background details on the recurring issues within Kenya's healthcare system, previous strikes, and potential solutions to avert the impending crisis.

Nakuru, Kenya – The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) has issued a two-week strike notice for doctors in the counties of Kajiado, Kilifi, Nakuru, and Embu. This ultimatum, delivered by KMPDU Secretary General Dr. Davji Atella, signals a deepening crisis in Kenya's public healthcare system, driven by what the union describes as a chronic failure by county governments to honor collective bargaining agreements (CBAs).
Background: A Long-Standing Struggle
The healthcare sector in Kenya has been marred by frequent industrial actions over the past decade, with doctors consistently at the forefront of these struggles. At the heart of these disputes are issues related to poor working conditions, inadequate pay, and delayed or unfulfilled promotions.
The origin of the current crisis can be traced back to the 2017 nationwide doctors’ strike, which lasted 100 days and brought the country’s healthcare system to a standstill. During this period, doctors fought for better working conditions, higher pay, and the implementation of the CBA that had been negotiated with the government. The strike ended with the government agreeing to the doctors’ demands, which included a 150-200% pay increase, employment of more doctors, job promotions, and better working conditions. However, the implementation of these agreements has been inconsistent, particularly at the county level.
The Current Dispute: Counties in Default
The present conflict centers around four counties—Kajiado, Kilifi, Nakuru, and Embu—that have been singled out by KMPDU for failing to implement the agreed-upon terms of the CBA. According to Dr. Atella, the counties have not only neglected to provide the agreed salary increments but have also failed to promote doctors who have met the necessary qualifications and experience.
In Kajiado and Kilifi, doctors have reported stagnant career progression, with many remaining in the same positions for years despite having completed the requisite training and gaining the necessary experience for promotion. This stagnation is not just a matter of professional frustration but has significant financial implications, as promotions are often tied to salary increases.
Nakuru, one of the largest counties in the Rift Valley, has been particularly criticized for its failure to address the systemic issues within its healthcare system. Reports indicate that despite the county’s significant budgetary allocation to health, doctors continue to work under deplorable conditions, with inadequate facilities and a lack of essential medical supplies.
In Embu, the situation is similarly dire. The county has been accused of withholding salary increments and failing to address doctors' grievances, leading to widespread discontent among healthcare workers.
The Social Health Insurance Act: A New Flashpoint
Adding to the tension is the newly enacted Social Health Insurance Act, which has drawn criticism from KMPDU. Dr. Atella has called for a review of the Act, arguing that it was rushed through Parliament without adequate consultation with key stakeholders, including healthcare providers. The union is concerned that the Act, while well-intentioned, may exacerbate existing problems within the healthcare system rather than resolve them.
The Social Health Insurance Act is intended to provide universal health coverage by making healthcare services more affordable and accessible. However, critics argue that the Act lacks clarity on how it will be funded and implemented, particularly in relation to healthcare providers' remuneration and working conditions. The fear is that without proper safeguards, the Act could place additional strain on an already overburdened healthcare system, further demoralizing doctors and other healthcare workers.
Historical Context: Repeated Strikes and Unmet Promises
The current strike threat is part of a broader pattern of industrial action in Kenya’s healthcare sector. Since devolution in 2013, which transferred health service delivery to county governments, the sector has been plagued by strikes. The decentralization was meant to bring services closer to the people, but it has also led to inconsistencies in healthcare delivery, with some counties performing better than others.
One of the most significant strikes occurred in 2017, when doctors demanded the implementation of the CBA that had been negotiated with the national government. This strike highlighted the deep-rooted issues in the sector, including underfunding, poor infrastructure, and a severe shortage of medical staff. Despite the eventual resolution of the strike, many of the issues raised at the time remain unresolved, contributing to the ongoing cycle of unrest.
More recently, in 2020, doctors in several counties went on strike to protest against the lack of personal protective equipment (PPE) and inadequate compensation for those working on the frontlines of the COVID-19 pandemic. The pandemic exposed the vulnerabilities in Kenya’s healthcare system, particularly at the county level, where resources are often stretched thin.
Key Sticking Points: What the Doctors Want
The KMPDU’s demands in the current dispute are clear and consistent with previous grievances:
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Implementation of Salary Increments: The union insists that the agreed-upon salary increases must be honored. The failure to implement these increments has left many doctors earning less than what was negotiated, a situation that is untenable given the rising cost of living.
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Timely Promotions: Many doctors in the affected counties have been working in the same positions for years without any prospects for advancement. This has led to widespread dissatisfaction and has affected morale, particularly among younger doctors who feel that their careers are stagnating.
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Improved Working Conditions: The union is calling for better working conditions, including adequate staffing, improved facilities, and the provision of essential medical supplies. The poor state of healthcare infrastructure in many counties is a major concern, as it not only affects doctors but also compromises patient care.
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Review of the Social Health Insurance Act: The KMPDU is calling for a comprehensive review of the Social Health Insurance Act to ensure that it addresses the concerns of healthcare providers. The union argues that without proper consultation and amendments, the Act could do more harm than good.
Potential Impact: What Lies Ahead
The potential impact of a strike in the four affected counties is significant. Kajiado, Kilifi, Nakuru, and Embu collectively serve a large portion of the Kenyan population, and a disruption in healthcare services could have serious consequences for patients. Essential services, including emergency care, maternal and child health, and treatment for chronic conditions, could be severely affected, leading to a healthcare crisis.
To avert this, there needs to be an urgent and concerted effort by the county governments to engage in meaningful dialogue with the KMPDU. The national government may also need to intervene to ensure that the CBAs are implemented and that the doctors’ grievances are addressed.
The Way Forward: Breaking the Cycle
Breaking the cycle of strikes in Kenya’s healthcare sector requires a multifaceted approach. One potential solution is the establishment of an independent oversight body tasked with ensuring that CBAs are implemented uniformly across all counties. This body could work closely with both the national and county governments to monitor progress and address any challenges that arise.
Additionally, there needs to be a more collaborative approach to healthcare reform, particularly in relation to the Social Health Insurance Act. Engaging healthcare professionals in the legislative process could help create a more balanced and effective healthcare policy that benefits both providers and patients.
Furthermore, counties must prioritize healthcare in their budgetary allocations. The sector has long suffered from underfunding, and without adequate financial resources, it will be difficult to address the systemic issues that have plagued the sector for years.
Conclusion: A Call for Urgent Action
As the two-week countdown begins, the healthcare sector in Kenya once again finds itself on the brink of a crisis. The demands of the KMPDU are not new, but they are urgent. For the sake of the millions of Kenyans who rely on public healthcare, it is imperative that the county governments take immediate action to resolve this dispute.
The resolution of this conflict will not only determine the immediate future of healthcare in the affected counties but also set a precedent for how similar disputes are handled across the country. The stakes are high, and the need for decisive leadership and action has never been greater.
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