By Kepher Otieno - Reporter
Kenya, 11 December 2025 - The collapse of negotiations between KMPDU and the Embu County government—extending the doctors’ strike into its 11th day—highlights a deeper crisis within devolved health governance: chronic human resource mismanagement, mistrust between unions and county administrations, and the absence of predictable promotion systems for medical personnel.
At the center of the standoff is the longstanding grievance over promotions, an issue that has resurfaced repeatedly across multiple counties since devolution.
In Embu, the dispute is not merely about paperwork; it reflects a breakdown of confidence in the county’s willingness to honor commitments.
KMPDU maintains that it will not call off the strike until all eligible doctors receive formal promotion letters, arguing that verbal assurances have been issued numerous times over the past two years without implementation. The union’s stance underscores a sentiment widely shared among healthcare workers nationwide—promises without written guarantees rarely translate into action.
The union’s insistence on written confirmation must also be understood within a broader historical context. Across the health sector, counties have frequently delayed or frozen promotions despite budgetary allocations, leaving doctors stagnant in the same job groups for years. This has fueled frustration, low morale, and periodic industrial action. In this sense, the Embu dispute is part of a larger systemic pattern rather than an isolated event.
The county government, however, is framing the situation differently. County Secretary Ammy Ruria argues that meeting the union’s demands through backdated or post-dated promotion letters would violate human resource procedures and expose Embu to audit risks. Her reasoning speaks to a bureaucratic rigidity that often clashes with the urgency expressed by frontline health workers.
Ruria’s comments also shift the conversation to procedural compliance—an argument that, while legally valid, risks appearing tone-deaf at a time when hospitals are experiencing significant service disruptions.
The county’s assertion that due process must be followed—vacancies declared, positions advertised, and promotions processed through the Public Service Board—reflects the procedural constraints of devolved HR systems.
Yet the question remains why these processes were not initiated earlier, especially if budgetary allocations for promotions already existed. This gap between legal procedure and timely action is a key driver of industrial unrest in county health systems.
Health CECM Jamal Runyenjes introduces yet another layer of complexity by attributing the strike partly to internal union politics ahead of KMPDU elections.
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While political maneuvering within unions is not unusual, framing the strike as election-driven risks deflecting attention from legitimate HR concerns. Such accusations also deepen mistrust between union members and county officials, making compromise even harder to achieve.
Runyenjes also disputes the number of doctors eligible for promotion, claiming only 11 qualify, contrary to the union’s figure of 19.
This numbers discrepancy reflects a common problem: inconsistent or poorly updated HR records within counties. When the employer and employee cannot even agree on who is eligible for promotion, negotiations naturally stall.
The broader impact of the strike is already being felt across Embu’s health facilities.
Extended industrial action often forces hospitals to scale down services, suspend elective procedures, and rely heavily on locum staff or overstretched non-striking personnel.
For patients in rural counties like Embu—where healthcare access is already fragile—the consequences can be profound.
As the strike enters its second week with no resolution in sight, the dispute has become emblematic of a larger national challenge: how to balance procedural compliance with the urgency of maintaining a functional healthcare workforce.
While counties emphasise legal processes, doctors highlight the human cost of bureaucratic delays. Without a structural overhaul of promotion systems, transparent HR record-keeping, and clearer accountability frameworks, such strikes will continue to resurface.
The Embu stalemate is therefore more than a dispute over letters—it is a test of how devolution manages, motivates, and retains critical healthcare personnel. For now, patients remain caught in the middle as both sides dig in, and a viable pathway to compromise remains uncertain.
