Confusion continues to surround the fate of more than 7,400 Universal Health Coverage (UHC) workers after governors rejected President William Ruto’s directive ordering counties to immediately absorb the personnel.
Barely a day after Ruto’s announcement, county bosses vowed to defy the directive unless the government releases Sh7.7 billion to facilitate their absorption on permanent and pensionable terms.
They are also demanding an additional Sh9.4 billion to clear gratuity arrears for staff under existing contracts.
“What the President is saying is not possible. We don’t have the money to absorb all of them. Unless they give us money, it will be difficult to implement his order,” a governor told the Star.
The county chiefs are set to meet next week to deliberate on the directive, which came just days after they opposed a similar order from the Ministry of Health.
Earlier, the ministry and the Council of Governors (CoG) had reached an agreement to retain the workers on the Salaries and Remuneration Commission salary scale until June 2026, when their salaries would be factored into the national budget.
Governors rejected the ministry’s initial plan for one-year funding, insisting that absorption must be anchored on sustainable financing.
“The ministry cannot alter the contracts of UHC staff without involving county governments,” CoG chair Ahmed Abdullahi said.
“The council will only accede to variations if the equitable share of revenue is increased to cater for them.”
On Thursday, however, President Ruto ordered the immediate absorption of the workers into permanent and pensionable terms. The directive contradicted the deal reached between the Health Ministry and CoG.
Speaking in Mombasa, where he issued employment letters to some of the workers, Ruto demanded that both levels of government resolve the stalemate and expedite absorption.
“Hawa wafanyikazi tunataka kuwatoa kutoka kwa kandarasi tuwafanye permanent and pensionable. Mimi nauliza counties hawa wafanyi kazi kuanzia mwezi huu wa tisa tuwaweke permanent and pensionable because we have the resources,” Ruto said.
His order came amid mounting pressure from UHC workers, who have staged several strikes over discriminatory terms compared to their colleagues on permanent and pensionable contracts.
The President also rebuked counties that have delayed stipends for Community Health Promoters, demanding that arrears be cleared within the week.
He praised Mombasa for leading in Social Health Authority (SHA) registration at 69 per cent, noting the county had already received more than Sh1.5 billion in SHA funds.
To ease tensions, the Ministry of Health and CoG had earlier agreed on a compromise: for the next 10 months, the ministry would pay the workers on enhanced terms starting September, after which counties would take over in the next financial year, once funds are allocated for the new package.
“In principle, the money we have this financial year is for county staff. But from September, they will be paid under SRC guidelines. Sh7.7 billion will be transferred and factored into the Division of Revenue Bill,” Health CS Aden Duale said.
Meanwhile, lawmakers have intensified pressure on Duale over persistent failures in rolling out the SHA.
The National Assembly Health Committee accused the ministry of mishandling the scheme, crippling hospitals and locking out patients.
“The idea is to make SHA work for the people. Because when you close a facility, it’s the patients who suffer, not those who made the mistakes. Deal with the individuals responsible, but let facilities operate,” committee chair James Nyikal said.
INSTANT ANALYSIS
UHC workers were initially recruited between 2019 and 2020 as part of the country’s broader effort to roll out the UHC programme, aimed at expanding access to essential health services by deploying additional staff, especially in underserved rural and peri-urban areas. The workers include nurses, clinical officers, public health officers, laboratory technicians, community health assistants and various support staff such as ambulance drivers and clerks. Though hired on contractual terms, they were assured that their positions would be converted to permanent and pensionable roles after a set period.
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