Revealed: Silent crises undermining Kenya’s universal health coverage plan
Stanley Ngara (right) engages with Principal Secretary for Public Health and Professional Standards Mary Muthoni (left) and Nation Media Group Chief Corporate Affairs and Partnerships Officer Monicah Ndung’u at National Syndemic Disease Control Council exhibition stand during the Health Summit event held at KICC in Nairobi on April 15, 2025.
As Kenya continues to pursue the dream of Universal Health Coverage (UHC), an unsettling reality casts a shadow over discussions at the Nation Health Summit, organised by the Nation Media Group, held at the Kenyatta International Convention Centre.
Healthcare workers, doctors, clinical officers, and nurses painted a starkly different picture: a crumbling workforce, broken promises, and a health system strained to the breaking point.
At the heart of the conversation was a growing frustration over the persistent strikes by healthcare workers and the structural injustices that hinder the achievement of UHC.
The healthcare workers were speaking during a panel discussion on the frequent strikes and challenges in achieving UHC delivery in the country, with a majority of them mentioning that they have for long been neglected, and this has hindered the delivery of a number of services.
Dr Abidan Mwachi, the national chairman of the Kenya Medical Practitioners, Pharmacists, and Dentists Union (KMPDU), didn't mince his words.
Panelists during a discussion at the Health Summit event held at KICC in Nairobi on April 15, 2025. The summit brought together healthcare professionals, policymakers, and industry leaders to discuss critical issues in public health and explore innovative solutions for improving health outcomes in the region.
“When governors say they’ve put mechanisms in place to ensure that people get services, they may be right, but what about the doctors who haven't been paid in months? What about the hospitals that have no equipment or drugs?” Dr Mwachi asked.
Strikes in the health sector, he said, are not driven by selfishness but by desperation.
“Doctors are human too. When they’re forced to sell their personal belongings just to get treatment, there’s something fundamentally broken in the system.”
Echoing him was Dr Davji Atellah, secretary-general of the doctors’ union.
“Many doctors in Kenya are working as consultants but are paid like interns. Doctors in Kiambu haven’t received their salaries in three months, yet they are expected to report to work daily, save lives, and smile through it all. That’s not sustainable,” said Dr Atellah.
The doctors recalled a painful history of broken commitments.
From the Collective Bargaining Agreement (CBA) disputes in 2011 and 2017 to the ongoing strike in 2024, the story remains the same: understaffed hospitals, delayed salaries, lack of essential medical equipment, and systemic neglect.
“When we sign agreements, they must be honoured,” Dr Atellah stressed.
“Strikes are never our first option; in fact, they’re our last. By the time we get to that point, we’ve tried every other means to be heard.”
From left: Amref Health Africa Country Director Meshack Ndirangu, Principal Secretary Public Health and Professional Standards Mary Muthoni and Nation Media Group Chief Corporate Affairs and Partnerships Officer Monicah Ndung’u cut a ribbon to officially open the Health Summit event held at Kenyatta International Conference Centre (KICC) in Nairobi on April 15, 2025.
Healthcare worker strikes have far-reaching consequences.
Compromised maternal care, delayed emergency responses, and the erosion of public confidence in the healthcare system are just a few.
Vulnerable populations suffer the most, particularly those who cannot afford private healthcare, which continues to be prohibitively expensive.
The doctors emphasised that investing in healthcare workers is not an expense — it's a necessity.
Yet, year after year, budget allocations prioritise flashy hospital buildings and new equipment over the human resources needed to run them.
“Why build more hospitals when we don’t have enough staff to operate the ones we already have?” asked Dr Peterson Wachira.
“We require over 11,000 doctors. Currently, we have just about 6,000. Our health system also needs 23,000 clinical officers, and we have only 7,000. We require 116,000 nurses by 2030 to meet UHC goals. Right now, we are not even halfway there.”
He added, “Our last Human Resource for Health strategy was in 2014. How can we talk about progress when we don’t even have a roadmap?”
Instead of addressing these critical gaps, recent graduates are paid as little as Sh500 a day, an amount so low it borders on exploitation.
“We are training more people, but absorbing very few. It’s a tragedy,” said Mr Austin Oduor Otieno of the Global Association of Clinical Officers and Physician Associates while sharing insights on the evolving role of mid-level health professionals said.
Psychological aspect
The toll on healthcare workers isn’t just financial; it’s psychological.
Dr Musa Nyandusi, representing the Directorate of Occupational Safety and Health in the Ministry of Labour revealed a disturbing trend: the rising mental health challenges, depression, and even suicide among doctors, particularly interns.
“Doctors are breaking under pressure. We have legal and policy frameworks, but there is a need to rework them. It’s time to take mental health in the workplace seriously,” he urged.
Mr Otieno indicated that Kenya’s failure to create a supportive work environment has contributed to a growing brain drain. Many trained doctors are migrating in search of better pay and working conditions.
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“We talk about achieving UHC, but how can we do that when we’re bleeding talent?” Dr Otieno said.
“If all our doctors were absorbed, properly remunerated, and supported, most wouldn’t even think about leaving. But until then, this exodus will continue.”
Despite the weight of their grievances, the doctors remained united in their commitment to serve.
“Our most comfortable place is not on the streets protesting,” Dr Atellah said.
Kenya Medical Practitioners, Pharmacists and Dentists Union Secretary-General Davji Atellah.
“It’s at the patient’s bedside. But to be there, we need a government that listens, respects, and fulfils its obligations.”
As the Nation Health Summit presses on, one truth stood out from the doctors’ panel: achieving UHC is not just about policies and plans. It’s about people. And unless the country invests in the well-being of its health workers, UHC will remain an elusive ideal.
Dr Atellah said “The question is no longer whether Kenya has the potential to achieve Universal Health Coverage; it’s whether the country is willing to make the hard but necessary choices to get there.”
