Take health back from counties, union tells state

Kenya Environmental Health and Public Health Practitioners Union National Secretary General Brown Ashira, during an interview on August 4, 2026. [Benard Orwongo, Standard]

Kenya Environmental Health and Public Health Practitioners Union (KEHPHPU) wants the health function returned to the national government, blaming devolution for the sector's persistent problems.

Speaking on Tuesday, July 4, during an interview on Spice FM, KEHPHPU National Secretary General and Chief Executive Officer Brown Ashira accused county governments of repeatedly failing to implement Collective Bargaining Agreements (CBAs) despite years of negotiations and signed agreements.

Ashira said the failure to honour CBAs sits at the centre of recurring health workers' strikes disrupting services in public hospitals.

"What appears to be simple issues are not being taken seriously. That is why we have these perennial strikes and why the health sector is in the state it is today," he said.

He argued the current devolved health system no longer works and should be reviewed.

"We need to agree that it is not working at the counties. Health should be under the national government. We cannot continue having the same issues year after year," he noted.

Ashira cited the plight of Universal Health Coverage (UHC) workers as one of the biggest unresolved labour issues in the sector. He said thousands of UHC workers have remained on contract for more than six years despite initially being employed on a three-year contract to support the government's UHC programme and help the country respond to the COVID-19 pandemic.

The contracts were later extended for another two years, a move he claimed contravenes labour laws.

"They work in the same environment as colleagues on permanent and pensionable terms but earn lower salaries, have no job security, cannot access loans or promotions and have continued to endure these hardships. This issue should be resolved once and for all," he explained.

Ashira blamed the continued standoff between the national and county governments for delaying solutions to the workers' challenges.

"The money is there, but the two levels of government are engaged in a blame game, with neither willing to take responsibility," he observed.

He said the national government handles national referral hospitals, regulation and policy, while counties oversee human resource management and county health facilities. The union wants health services managed entirely by the national government, saying this would ensure uniform implementation of labour agreements and improve service delivery.

"We want health to be domiciled under the national government, just like education and security, so that implementation of healthcare services is seamless," Ashira said.

He accused both levels of government of ignoring the union's demands despite a 21-day demand notice followed by a 14-day strike notice.

"The notices expired without any invitation for dialogue. We are always ready to sit down and agree, but we have developed a culture of signing agreements and failing to implement them," he added.

Ashira maintained that strikes remain a last resort and blamed the crisis on governments' failure to implement CBAs, address staffing shortages, renew UHC contracts and improve terms of service for health workers.

The ongoing strike has severely disrupted healthcare services across public hospitals, with inpatient admissions, routine clinics and emergency services affected, forcing patients to seek expensive treatment in private hospitals or endure long delays.

Ashira also criticised President William Ruto, saying he has the constitutional authority to intervene and end the impasse.

"The President has all the legal powers to resolve these issues. If he took charge and ensured the agreements were implemented, this strike would be called off," Ashira said.