I hold a diploma but earn certificate wages: UHC medics stage final budget plea as healthcare crisis deepens

As Parliament finalised the 2025-2026 budgetary allocations on Tuesday, 8,571 Universal Health Coverage (UHC) medics gathered outside the National Assembly in a desperate final plea. These healthcare workers, hired by the government in 2020 and deployed across all 47 counties, are demanding the fulfilment of promises made five years ago for permanent and pensionable terms (PnPs) as well as gratuity payments.

With Treasury Cabinet Secretary John Mbadi set to deliver the budget reading this Thursday, the medics' demonstration represents their last attempt after 18 weeks of nationwide protests to secure the Sh6.1 billion needed for their employment regularisation.

Stories of struggle from the frontlines

The human cost of the government's unfulfilled promises becomes clear through the voices of those who have served Kenya's healthcare system for half a decade.

Dedan Mwenda, a UHC medic from Tharaka Nithi County, travelled overnight to join the protest. "Under UHC, instead of serving as a registered nurse—which I am qualified for as a diploma holder—I was employed as an enrolled nurse, a certificate-level position where I earn Sh10,000 less than what I should be earning as a registered nurse. It's demoralising," he explained.

Also read: The forgotten frontliners: UHC workers speak out

Despite holding the key position of facility in-charge at a well-performing health facility, Mwenda struggles financially. 

"I earn peanuts and cannot even afford my own rent. I have been thrown back and forth between the county and the Health ministry to a point where my head is spinning."

The challenges extend beyond individual hardship to family responsibilities that require urgent medical attention. Apusa Ochieng’, a UHC nurse from Migori County, made the journey to Nairobi as a single mother caring for an epileptic child.

"I travelled all the way from Migori County to camp outside the National Assembly because I am a single mother to an epileptic child. PnP terms will enable me to have medical cover that will help me take better care of him," she said.

Ms Ochieng’ detailed the daily financial strain: "Apart from other normal basic needs, I need to constantly buy medication, which is very expensive. My son currently depends on sodium valproate tablets to stay alive, and it has been very difficult purchasing the drugs, which he takes twice daily, morning and evening. He also needs regular testing, which is very expensive."

The Sh50,000 stipend she receives is heavily taxed and insufficient for her needs. 

"I humbly plead with MPs as well as Treasury to consider sorting out our PnPs and gratuity in full. I also need to go back to school and take care of myself as a woman."

Remote hardships and constitutional violations

Perhaps no story illustrates the harsh realities faced by UHC medics better than that of Dennis Nyabuto, a medical laboratory officer who travelled from North Horr in Marsabit County to join the demonstrations. Working in one of Kenya's most challenging environments, Nyabuto serves a population of up to 14,000 people whilst earning just Sh30,000—a taxed stipend with no hardship allowances.

"Five years working under punitive contracts contravenes the labour laws of our republic and the International Labour Organisation (ILO) Convention, Article 41(3) of the Constitution 2010, and the Employment Act 2007, which all dictate equal remuneration for equal work and equal pay," he stated.

The harsh realities of his posting are stark: "In North Horr, I purchase basic foodstuffs at hiked prices—an egg costs Sh25, a tiny cabbage costs Sh200, and you need to buy fresh drinking water daily. With temperatures reaching 39°C on a normal day, you spend more money."

Nyabuto works nightshifts combined with normal shifts and outreach programs, yet receives no medical service allowance and cannot access social health insurance. The nearest hospital is 200 kilometres away—a six-hour journey through areas with high insecurity rates and no proper roads.

"I am only still alive by the grace of God because in 2021, I was bitten by a wild dog and got rabies when even our own facility didn't have an anti-rabies vaccine. I had to travel to a hospital 200 kilometres away," he recounted.

Both the health ministry and the Council of Governors have admitted on record that the contracts given to UHC medics are no longer tenable.

The standoff continues

UHC National Chair Desmond Wafula made it clear that the medics' resolve remains unshaken. "If Parliament doesn't include the UHC medics in the budget yet again for the fifth consecutive year, we will continue protesting every Tuesday until they do so. We will never return to work."

Wafula emphasised the broader implications of the ongoing crisis: "These health professionals have been the backbone of Kenya's healthcare system, yet have endured five years of uncertainty, exploitation, and emotional distress due to unresolved employment terms."

He noted that UHC staff have been incorporated in the current budgetary estimates with an allocation of Sh6.1 billion out of the Sh4.2 trillion national budget, according to Samuel Atandi, chair of the budget appropriations committee.

Healthcare system under strain

The impact of the unresolved employment terms extends far beyond individual hardship, affecting Kenya's entire healthcare delivery system.

"The adverse effects are already manifesting," Wafula warned. "Several health facilities, especially those heavily reliant on UHC staff, have scaled down operations or shut down entirely. Blood banks have closed, and many 24-hour hospitals now operate for less than 12 hours due to staffing shortages."

He stressed the life-and-death implications: "These disruptions are not abstract—they have immediate consequences for Kenyan citizens. Transitioning UHC staff to permanent terms would stabilise healthcare delivery, restore full operation in affected facilities, and ultimately save lives."

The UHC national chair called for strategic thinking in budget allocation: "The budget must reflect the strategic value of retaining experienced staff who are already integrated into healthcare systems rather than opting for costly, inefficient mass recruitment exercises that overlook existing expertise."

As Thursday's budget reading approaches, the fate of Kenya's healthcare system hangs in the balance, with 8,571 medics and millions of patients awaiting a resolution to a crisis five years in the making.

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