By Pascal Ndegwa - Reporter
Kenya ,October 13 ,2026 - Nurses and midwives at Kenyatta National Hospital (KNH) have secured a new Collective Bargaining Agreement with hospital management, ending a strike that disrupted services at Kenya’s largest referral hospital. The 2025–2029 agreement goes beyond higher allowances, offering structured promotions, improved medical cover and a pathway for contract nurses to move to permanent and pensionable employment.
The deal followed a return-to-work formula signed after a two-day strike that began on April 13, 2026. Nurses had protested the non-implementation of a CBA addendum dated September 8, 2025, inadequate medical cover, heavy workloads and insecure contract employment.
Under the agreement, nurses will receive a KSh25,000 uniform allowance and a KSh30,000 nursing service allowance. The health risk allowance has been set at KSh5,000, while the leave allowance will be one-third of basic salary, capped at KSh50,000. KNH also committed to paying extraneous allowances in line with Salaries and Remuneration Commission standards.
The hospital further agreed to improve medical cover through a framework for interim specialised care, strengthen staff welfare and implement structured promotions. Perhaps most significantly, KNH undertook to progressively convert nurses on contract terms into permanent and pensionable employees, addressing one of the union’s central demands.
KNH also committed to easing the staffing shortage by recruiting 100 nurses through a KSh364 million government allocation and engaging 100 Health Care Assistants. However, the additional staff will only partly close the gap: the hospital had about 2,300 nurses against a recommended establishment of 2,800 at the time of the strike, leaving it roughly 500 nurses short.
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Nurses had also raised concerns over a nurse-to-patient ratio of 1:35, a workload they argued compromised both staff welfare and patient care. The new agreement provides a starting point for addressing the shortage, but sustained recruitment, retention and workload management will be needed to bring staffing to safe levels.
Other commitments include remitting third-party deductions by the 15th of each month from the next financial year and ensuring that retiring staff receive their pensions as they fall due. These measures target administrative delays that have previously affected nurses’ financial security.
The agreement has implications beyond the nursing workforce. KNH receives patients from across the country, many referred for specialised treatment, surgery, cancer care and intensive care. Any disruption in nursing services affects waiting times, admissions and continuity of care, making nurse welfare and adequate staffing a direct patient-safety issue.
The CBA now faces its most important test: implementation. Nurses and patients will be watching whether allowances are paid on time, contract nurses are converted as promised, promotions are processed and the additional staff are recruited. If delivered, the agreement could restore confidence among KNH’s nursing staff and improve service delivery. If it stalls, the hospital risks repeating the cycle of strikes, unfulfilled promises and strained relations between management and frontline health workers.