Health Cabinet Secretary Aden Duale when he appeared before the National Assembly health committee chaired by Seme MP Dr James Nyika at the Parliament buildings Nairobi on Thursday, May 15, 2025. DENNIS ONSONGO| NATION
Duale in Spot as Council of Governors and Ministry Clash Over 7,000 UHC Health Workers
NAIROBI, Kenya — What began as a prolonged labor grievance has escalated into an institutional turf war between county bosses and the national government, leaving more than 7,000 Universal Health Coverage (UHC) health workers trapped in employment limbo.
The Council of Governors (CoG) and the Ministry of Health, led by Cabinet Secretary Aden Duale, have exchanged blistering correspondence over who bears the legal and financial responsibility to absorb the workers into permanent and pensionable terms — a commitment now delayed for six years. +-----------------------------------------------------------------+ | THE UHC WORKERS STANDOFF | +-----------------------------------------------------------------+ | MINISTRY OF HEALTH (Afya House) | COUNCIL OF GOVERNORS | | ------------------------------- | ----------------------- | | • Directs County Boards to | • Rejects central | | integrate UHC payroll data. | payroll transfer. | | • Cites Cabinet approval & | • Demands long-term | | Sh9B conditional grant. | Equitable Share. | | • Argues terms are finalized. | • Warns 1-year grant | | | risks fiscal deficit. | +-----------------------------------------------------------------+
The Escalation
The standoff intensified following communications from top public service officials. Dr. Jane Imbunya, Principal Secretary at the State Department for Public Service and Human Capital Development, wrote to Medical Services PS Dr. Ouma Oluga confirming that transition data for over 7,000 UHC staff was ready. Dr. Oluga subsequently directed County Public Service Boards to absorb the staff onto county payrolls.
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The directives met immediate resistance from county leadership. Mombasa Governor AbdulSwamad Nassir, who chairs the CoG Health Committee, firmly rejected the central transfer, noting that migrating payroll data is untenable without resolving funding guarantees.
CoG Chairman Ahmed Abdullahi dismissed the Ministry’s authority, stating that a Principal Secretary lacks constitutional powers to instruct county public service boards on employment matters. The Council has advised county boards to disregard the Ministry’s letters entirely.
“A PS has no powers to instruct governors. How can a PS instruct county public service boards to put people on the payroll yet there is no allocation? They do not seem to understand their roles.”
— Ahmed Abdullahi, Chair, Council of Governors
Financing Breakdown
At the core of the impasse is the mode of financing:
- The Ministry’s Position: Health CS Aden Duale announced that all UHC staff would transition to permanent contracts funded through the Division of Revenue framework, backed by a Sh9 billion allocation.
- The Counties’ Counter-Argument: Governors emphasize that the funds are structured as a one-year conditional grant under the County Government Additional Allocation Act. Because conditional grants can be withdrawn, counties argue they cannot offer open-ended, permanent employment contracts on temporary financing lines.
The Council of Governors insists the allocation must be channeled through the Division of Revenue Act as part of the equitable share—a constitutionally protected transfer—before counties issue permanent appointment letters.
Impact on Healthcare
The administrative deadlock comes at a high cost to public healthcare. Originally hired during the COVID-19 pandemic on short-term contracts, UHC staff have been on strike since late June 2026, demanding formal appointment letters and unpaid 30% salary gratuities. With key facilities facing service disruptions, both levels of government remain at an impasse while health workers await a clear resolution.
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