Why govt must power UHC amid concerns over health funding crisis

As Kenya grapples with growing concerns over healthcare financing, staffing shortages, and mounting pressure on public hospitals, experts now warn that the success of Universal Health Coverage (UHC) will largely depend on how well the government supports and retains frontline healthcare workers, particularly nurses.

For years, debate around Kenya’s healthcare crisis has focused on hospitals, medicine, equipment, and budgets. But health leaders say the country’s healthcare system is ultimately sustained by nurses, who continue to shoulder the burden of patient care across both urban and rural facilities.

The renewed focus on nurses dominated discussions during International Nurses Week 2026, where healthcare leaders called for increased investment in nursing leadership, better working conditions, and long-term workforce stability as the country expands UHC.

The conversation comes at a critical time when Kenya is facing a growing health funding crisis, persistent workforce shortages, rising cases of non-communicable diseases, and increasing demand for affordable healthcare services.

According to Public Health and Professional Standards Principal Secretary Mary Muthoni, nurses remain central to Kenya’s healthcare delivery system, especially at the grassroots, where millions of Kenyans access primary healthcare.

“The Government of Kenya recognises and greatly values the critical role nurses play in the delivery of Universal Health Coverage. Nurses are the backbone of our health system, providing frontline healthcare and strengthening communities across the country,” she said.

Her remarks reflect the reality in many rural and underserved regions where nurses are often the first and sometimes only healthcare professionals available. They oversee maternal healthcare, childhood immunisation, disease prevention, emergency response, and management of chronic illnesses in Level 2 and Level 3 facilities.

PS Muthoni noted that nurses manage nearly 75 per cent of these facilities nationwide, making them indispensable to the country’s primary healthcare agenda.

Health analysts warn that the increasing dependence on nurses is happening at a time when healthcare workers are struggling with burnout, understaffing, and migration to foreign countries offering better pay and working conditions.

UHC bane

Across public and private hospitals, nurses continue to face long shifts, emotional strain, and rising patient numbers, factors that experts say could undermine UHC implementation if left unresolved.

At The Nairobi Hospital, hospital leadership acknowledged that quality healthcare cannot be achieved without investing in nurses and improving their welfare.

Chief Executive Officer Felix Osano described nurses as central to patient care and institutional performance.

“Our nurses embody the very essence of who we are as an institution. Their dedication, commitment, and selfless service continue to ensure safe, high-quality patient experiences,” he said.

Globally, healthcare systems are increasingly prioritising nurse specialisation, leadership development, and mental wellness support as part of broader efforts to improve patient outcomes and strengthen healthcare resilience.

Healthcare experts say the COVID-19 pandemic further exposed how critical nurses are during health emergencies, while also revealing weaknesses in staffing and healthcare preparedness.

In Kenya, those concerns have now evolved into fears over retention and migration, with thousands of Kenyan nurses seeking employment opportunities abroad, particularly in the United Kingdom, the United States, and Gulf countries.

The migration trend has intensified concerns over a potential brain drain that could further weaken Kenya’s already stretched healthcare system.

In response, the government says it is implementing policy reforms aimed at improving working conditions and career growth for healthcare workers.

“The Government is focused on policies and investments aimed at improving training, working conditions, career progression, leadership development, and nurses’ retention,” PS Muthoni said.

Duale on UHC

Part of those reforms now includes plans to absorb thousands of UHC workers into permanent employment after years of uncertainty over their contracts.

Health Cabinet Secretary Aden Duale announced that at least 7,414 UHC staff will officially transition to permanent and pensionable terms beginning July 1, at the start of the 2026/27 financial year.

Speaking during the International Nurses Week celebrations on Tuesday, May 12, 2026,  Duale said the workers’ contracts had been extended to June 30 pending the transition.

“Let me make it very clear, our UHC staff, we have extended your contract up to June 30,” Duale announced.

“The money for permanent and pensionable terms beginning July 1 is already factored into the budget and is in the division of revenue.”

According to the CS, county governments will employ the UHC nurses once the transition begins, adding that the ministry will publicly release the names of beneficiaries and their assigned counties to ensure transparency.

“For integrity and transparency and accountability, when that time of transition comes, I will advertise the nurses that will transition on our website, county by county, name by name, so that no monkey business is done in between,” he said.

Duale further stated that the workers currently being paid by the ministry will be prioritised for permanent employment.

The announcement follows months of uncertainty and negotiations between the national government, county governments, and UHC workers over delayed plans to absorb them into permanent terms due to funding challenges.

The workers had initially expected to be absorbed as early as September 2025 after an earlier government commitment, but the process stalled amid insufficient budgetary allocations.

Healthcare leaders say such delays continue to expose the broader financing challenges facing Kenya’s healthcare system, even as the government pushes forward with ambitious UHC reforms.

Director of Nursing Services at The Nairobi Hospital, Margaret Muiyuro, argued that strengthening healthcare systems will require nurses to be empowered not only as caregivers but also as leaders and decision-makers.

“Nursing is a calling grounded in compassion, professionalism, and a commitment to patient-centred care. Investing in nurses directly improves patient outcomes and strengthens healthcare systems,” she said.

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