NAIROBI, Kenya – Governors have dismissed President William Ruto’s directive requiring counties to immediately absorb more than 7,400 Universal Health Coverage (UHC) workers, escalating tensions between the national and county governments over staffing costs in the health sector.
The county chiefs argue they cannot comply with the order unless the National Treasury releases at least Sh7.7 billion to fund the conversion of the workers’ contracts into permanent and pensionable terms.
They also want Sh9.4 billion to clear gratuity arrears for staff whose contracts are expiring.
Ruto, while issuing appointment letters to some of the workers in Mombasa this week, had directed counties to immediately put them on permanent terms, insisting that both levels of government must move quickly to end uncertainty.
“We want to take these workers off contract and make them permanent and pensionable. I am calling on the counties to formalise these workers starting this September because we have the resources,” Ruto said.
The pronouncement contradicted a recent agreement between the Ministry of Health and the Council of Governors (CoG), which had resolved that the UHC staff would remain on Salaries and Remuneration Commission (SRC) pay scales until June 2026, when their salaries would be absorbed into the national budget.
CoG chair Ahmed Abdullahi maintained that the ministry cannot alter contracts without county consent, saying the council would only accept changes if the equitable share of revenue was increased.
Governors are expected to convene next week to deliberate on the directive, leaving the fate of the UHC workers uncertain.
The employees have staged multiple protests demanding equal treatment with their permanent colleagues.
The standoff comes as Health CS Aden Duale announced a temporary plan under which the ministry would continue paying the workers on improved terms for 10 months starting September, before handing them over to counties in the next financial year once additional resources are allocated.
“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,” Duale explained.
Ruto also took issue with counties that have delayed paying Community Health Promoters (CHPs), ordering them to settle arrears this week.
He commended Mombasa County for achieving 69% registration under the Social Health Authority (SHA), earning more than Sh1.5 billion in allocations.
The employment impasse piles pressure on the government’s flagship UHC programme, which has faced repeated delays and financing disputes since its rollout under the Bottom-Up Economic Transformation Agenda (BETA).
