Nairobi — The health sector is grappling with a looming Sh46 billion budget shortfall that could disrupt critical services, including the hiring of Universal Health Coverage (UHC) workers, delivery of HIV and TB care, and supply of essential vaccines.
The funding gap was revealed in submissions by the National Assembly's Health Committee to the Budget and Appropriations Committee, amid the suspension of key donor support particularly from the United States, a long-time backer of Kenya's HIV programs.
According to the committee, the Ministry of Health urgently needs Sh33.9 billion to sustain HIV and TB interventions, which are at risk due to the donor funding freeze. An additional Sh8.8 billion is required to recruit 8,500 healthcare workers under the UHC program.
The Ministry is also short of Sh4.2 billion needed to procure vital HIV, family planning, and vaccine commodities. Health Committee Chair Dr. James Nyikal (Seme) explained that this amount is counterpart funding under GAVI and UNICEF agreements.
"If we don't secure this funding, we'll incur even higher costs later," Nyikal told the budget team chaired by Alego Usonga MP Sam Atandi.
Nyikal stressed the urgency of resolving the plight of UHC staff, whose contracts expire in May 2026.
Though Treasury has set aside Sh4 billion for their stipends, more funding is needed to address ongoing strikes and workforce instability.
The ministry estimates Sh5 billion will be required to settle their dues at contract expiry, and another Sh3.8 billion to transition them into permanent and pensionable roles.
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"These workers are critical for achieving universal healthcare across all 47 counties. If we don't resolve their concerns, they'll remain on the streets protesting," Nyikal warned.
Kiharu MP Ndindi Nyoro echoed these sentiments, calling the Sh3.8 billion needed for permanent employment "a small price" for strengthening healthcare services and addressing youth unemployment.
The UHC workers have been on a 96-day strike demanding permanent contracts, pay harmonization, payment of overdue gratuities, and a defined budget allocation in the 2025/26 financial year.
They are also pushing to receive their gratuities before their payroll is moved to county governments on July 1, 2025.
Health Cabinet Secretary Aden Duale recently announced the payroll transfer, but the Council of Governors (CoG) has pushed back, citing lack of adequate funding, unclear communication from the national government, and discriminatory employment structures.
CoG Chair Ahmed Abdullahi stated that counties would not accept the payroll transfer unless it comes with sufficient funding and clear policy direction.
"We have not officially received the UHC payroll and will not absorb it without the necessary support," he said.
UHC workers are demanding full absorption into the permanent public workforce, salary alignment with Salaries and Remuneration Commission (SRC) guidelines, and compensation for the years they have served under contract demands that remain unresolved as the health sector teeters on the edge of crisis.
