The health crisis in Kenya continues to escalate as the nationwide strike by doctors, clinical officers, and laboratory officers enters its fifth week.

The conflict pitting the healthcare workers and the government looks far from over as both sides hold on their extreme positions.

Health Cabinet Secretary Susan Nakhumicha is, however, appealing to the striking medics to return to the negotiating table and assuring the public that the government is working to find an "amicable and long-lasting solution."

Speaking in Ngong, Kajiado county, during the commissioning of a mental hospital managed by the Catholic church, Nakhumicha said the going strike would end this week.

“My assurance to the public is that, as government, we are working round the clock to ensure an amicable and long-lasting solution is reached. If not today, by the end of this week,” said the CS.

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She said the government will make sure that the doctors resume duty.

"Indeed, I can confirm that most of the issues raised by the unions have been agreed upon and the few remaining sticking issues will soon be resolved to return the sector to normalcy," Nakhumicha said.

She was accompanied by Kajiado Deputy Governor Martin Moshisho.

The CS thanked private and faith-based facilities for opening their doors and treating patients during the doctors' strike.

The Council of Governors (CoG) has, however, taken a firm stance, warning that the implementation of the doctors' 2017 Collective Bargaining Agreement (CBA) will have a "ripple effect" on civil servants' basic salaries.

"If the national government agrees to the implementation of the CBA, we would like to bring to the attention of the national government and the public that this would have a ripple effect on all civil servants' basic pay and will therefore require additional allocation of resources to county governments to be able to carry out this task," CoG chairperson Ann Waiguru said, threatening to take disciplinary action against healthcare workers who fail to resume duty, a move that has been condemned by the Kenya Medical Practitioners and Dentists Union (KMPDU).

The CoG's position reflects the concerns of the county governments, which are the direct employers of the healthcare workers.

KMPDU Secretary-General Davji Atella accused the governors of lacking empathy and disregarding the concerns of healthcare workers.

"It is not right that you demand for allocation of funds to the county to build hospitals, but you have no regards for the healthcare workers working in those facilities," Dr Atella said during yesterday’s protests outside the CoG’s office in Nairobi.

The doctors have remained resolute in their demands, which include the implementation of the 2017-2021 CBA, the posting of medical interns, and other critical issues.

Hundreds of healthcare workers took to the streets of Nairobi, marching from the Kenyatta National Hospital to the Ministry of Health headquarters and the CoG office, vowing to continue their strike until their demands are met.

The ongoing dispute has brought to light the longstanding issue of inadequate funding and resources for county governments.

Furthermore, Waiguru urged the unions to engage directly with their respective county governments, as stipulated in the Constitution.

"If a decision is made on the implementation of CBAs, that would like to bring to the attention of all the stakeholders that this would have a ripple effect across all cadres in the public service in the counties and will therefore require additional resources to the counties. In addition, we would like to urge and request the unions to engage their respective employers who are the county governments as provided for in the Constitution," she said.

Waiguru emphasized the need for additional resources to be provided to the counties to facilitate the implementation of the CBA, should it be agreed upon.

Furthermore, Waiguru urged the unions to engage directly with their respective county governments, as stipulated in the Constitution.

The CoG decried the lack of funding from the national government, stating that they have been relegated to "mere implementing agents of national government policies, with little to no say in the allocation of resources."

In a statement, the COGs added that this has severely hampered their ability to fulfill their constitutional mandate of serving the people at the county level.

The statement further highlighted the insufficient transfer of functions and resources from the national to county governments, as stipulated in the 2010 Constitution.

 "Many essential services and functions remain under the control of national ministries and agencies, depriving counties of the autonomy and resources needed to effectively govern," the statement said.

Inadequate funding for county governments has been a longstanding issue, with most relying heavily on national government transfers to finance their operations and development projects.

"We are essentially operating on a shoestring budget, which makes it extremely difficult to deliver quality public services and meet the growing needs of our constituents," the statement said.

As the crisis deepens, both the healthcare workers and the county governments are calling for a comprehensive solution that addresses the underlying challenges in the healthcare system.

Additional report by Peterson Githaiga