County governments and the Kenya Union of Clinical Officers (KUCO) have signed a new Collective Bargaining Agreement (CBA), ending eight years of stalled negotiations and repeated industrial action.

The agreement, finalised on February 2, 2026, applies to clinical officers working in county health facilities across Kenya. It promises better pay, clearer career progression and improved working conditions, bringing relief after years of tension in the public health sector.

Talks began soon after KUCO was formed in 2017 but made little progress from around 2018. Clinical officers demanded fair salaries, recognition of their role, improved allowances, job security and clear rules on promotions and disciplinary processes.

The delays caused widespread frustration and led to demonstrations and frequent strikes, which disrupted healthcare services in many counties.

The breakthrough came after a 36-day nationwide strike that started on December 23, 2025. Hospitals and clinics across the country faced serious disruption as clinical officers pushed for action on long-standing promises and a fresh CBA.

On January 28, 2026, KUCO and the Council of Governors (CoG) signed a return-to-work formula. The agreement saw clinical officers resume duty within 24 hours and cleared the way for the final CBA signing a few days later.

Speaking after the return-to-work deal, KUCO Secretary General George Gibore called on county governments to honour their commitments.

“We urge the County Government to do their part; if they do so, we shall be there to support them when required,” Gibore said.

“On that note, we have said that the strike has been suspended and the clinicians will resume work today, not past 24 hours. We shall issue a notice to our employer that we have directed the clinicians to go back to work.”

Pay reforms and oversight

The new CBA includes strict oversight measures to ensure proper implementation. Central to this is the CBA Implementation Monitoring Committee, which will track how counties roll out the agreement.

The committee has nine members, with five drawn from county governments and four from KUCO. It will meet at least once every three months, or more often if either side requests. The chairperson will call quarterly meetings, and all 47 counties must establish and operate the committee to address emerging issues.

The agreement covers the full career cycle of clinical officers. It outlines terms for recruitment, training, promotion, salaries, allowances, medical cover and retirement.

Reports indicate that the new pay structure includes immediate salary adjustments. Some clinical officers could earn up to Ksh338,000 under the revised scales. The deal also provides for a minimum Ksh10,000 salary increase and a fixed risk allowance of Ksh4,000. Many officers will move from contract positions to permanent and pensionable terms.

The long negotiations exposed deeper issues in labour relations. During the strike, clinical officers held protests outside the Ministry of Health offices in Nairobi, accusing authorities of failing to honour earlier agreements.