Kenya’s healthcare sector is facing mounting pressure as health workers and other public servants grapple with delayed salaries, disputed pay, and prolonged arrears that have disrupted health services nationwide. Reports from across the country show that in late 2025 and early 2026, clinics, hospitals, and frontline medical teams experienced repeated disruptions linked to unpaid or delayed wages that have lasted for months in some cases. While no single government report states that all health workers have gone 19 months without pay, multiple credible sources confirm that long delays in remuneration have become a persistent and serious problem in Kenya’s public health sector.
Persistent Salary Delays and Unpaid Obligations
A key Parliamentary Budget Office (PBO) report reveals that the state owed about Sh4 billion in unpaid obligations to doctors and Community Health Promoters (CHPs) as of June 2025. Of this amount, the national government owed more than Sh2 billion to over 107,000 CHPs, while county governments carried about Sh1.8 billion owed to doctors for delayed salaries and allowances across multiple counties.
The Controller of Budget report covering late 2025 also highlighted a broader crisis: unpaid salary bills by state corporations more than tripled in the period between July and September 2025, rising from about Sh10.5 billion to Sh37.3 billion. At the same time, unremitted health insurance contributions jumped to Sh39 billion, all contributing to a total of over Sh66 billion in salary and health stall arrears within the public sector. These figures help explain why many health workers across regions have repeatedly protested and in some cases withdrawn their services in workplaces from county hospitals to national facilities.
Strikes, Protests and Operational Disruption
Health workers in counties such as Kiambu and Nairobi have staged demonstrations over delayed wages and poor working conditions. In Nairobi City County, hundreds of workers nurses, clinical officers, laboratory technicians, dentists, and other cadres protested unresolved salary delays dating back to mid‑2025, saying missed pay has pushed workers to financial hardship and eviction threats.
In other regions, industrial action has directly affected health service delivery. For example, Clinical officers in Marsabit County entered a strike after several months of unpaid wages and unresolved agreements, leaving many public health facilities without full staff and forcing patients to seek care far from home. In Kiambu County, doctors led prolonged strikes over salary arrears and other labour grievances, with reports indicating that some actions lasted months, disrupting maternity and emergency services. In Nairobi, clinicians’ protests continued into early 2026, with health services reportedly paralysed in public hospitals as doctors and clinical officers withdrew services over unresolved pay disputes. Although some counties have responded by pledging payments or contesting the claims of unpaid wages, workers and unions have maintained that delays remain widespread and harmful to both staff welfare and healthcare access.
Long‑Term Wage Issues and Government Response
The salary challenges are not limited to recent months. Previous reports show that medical interns, for example, faced months of unpaid salaries in 2024, prompting government commitments to clear backlogs and release funds for unresolved payroll issues. Additionally, campaigns to pay longstanding pay arrears, such as seven years of Basic Salary Arrears for doctors under the Collective Bargaining Agreement (CBA), resulted in releases totalling Sh3.5 billion, signaling efforts to resolve some historical disputes.
Nevertheless, systemic issues remain. The health sector’s financing and human resource management challenges, especially under Kenya’s devolved model of governance, have left many local units struggling to meet payroll obligations. Experts have attributed strikes and unrest to weak leadership, financing gaps, and delays in statutory deduction remittances all contributing to low morale among healthcare professionals and intermittent service delivery.
Impact on Patients and Communities
The consequences of these payment delays are felt beyond staff welfare. When health workers strike or reduce their services, patients face longer wait times, limited access to essential care, and increased pressure on neighbouring facilities. In several counties, community members have had to travel greater distances for basic medical attention a situation especially hard on vulnerable groups such as mothers, children, and chronically ill patients.
Beyond immediate health impacts, prolonged salary arrears erode confidence in public institutions and can deepen workforce shortages at a time when Kenya is working to expand healthcare coverage and improve public health outcomes.
A Call for Sustainable Solutions
The complexity of health worker salary delays highlights the need for both short‑term relief and long‑term structural reform. Addressing persistent arrears, such as the Sh4 billion owed to doctors and CHPs, requires coordinated action between national and county governments to ensure consistent salary payments and timely statutory deductions. Reforming payroll systems, enhancing human resource planning, and improving financial flows to devolved units are critical to stabilising the health workforce and maintaining service delivery. Strengthening accountability, transparent budgeting, and proactive dialogue with unions can also help prevent recurring disputes that harm both workers and patients.
In a sector where human capital is its core asset, ensuring that health professionals are paid reliably is not only a matter of fairness it is essential for a functional and resilient healthcare system.
