National, County Governments clash over payment of doctors on postgraduate training

Health CS Aden Duale (centre), PS Public Health and Professional Standards Mary Muthoni, Director of Medical Services Patrick Amoth before the National Assembly's Health committee to consider Budget Estimates FY 2025/26 at Parliament Buildings, Nairobi, on May 15, 2025.[File-Standard]

Following complains of shortage of health care workers the government is stepping up by increasing recruitment, postgraduate training and improved workforce planning.

Speaking at the Health Summit 2026, Principal Secretary State Department for Public Health and Professional Studies Mary Muthoni said the government is focusing on ensuring health facilities had the right number of workers with the appropriate skills.

“Just the other day, we have been able to transition our UHC staff from contract to permanent and pensionable, and the counties every other time they are employing to ensure that our facilities have the requisite numbers to treat the people of Kenya,” Said Muthoni

The government is also encouraging health workers to pursue postgraduate training to acquire specialised skills.

“I keep telling the health care workers, niko na pesa ya kupeleka shule (I have money to take you to school). You only need to apply so that we can take you for postgraduate training,” She said

She however emphasized that training must be guided by the actual needs of counties rather than individual preferences.

We are talking about equitable distribution again, so that we are very clear on who we require in every county and every corner and in all facilities.  As we also send you for postgraduate training, we will be very keen to know how many Obgyns are in Tharakanithi County versus the ones in Mombasa County as equivalent to the population, “said Muthoni

Her sentiments were echoed by Council of Governors Health Committee Chairperson ,Tharaka Nithi Governor Muthomi Njuki who called for a comprehensive needs assessment before medical officers are sent for postgraduate training.

“Sometimes we are taking training depending on the doctor's need, and not the county or the employer's needs. We also have a problem when we take them for training, the counties continue paying salaries and therefore we have gaps that have been left in human resource that we cannot able to address,” Said Muthomi

Muthoni requested the national government and Ministry of Health to take over the cost of postgraduate training and salaries for health workers during the training period.

“So that we can fill that gap by having maybe contracts for those who would wish to cover for one or two years,”

However, the Cabinet Secretary for Health Aden Duale, differed with the proposal maintaining that the county governments should pay the doctors and not the national government.

“We are in agreement, that the specialty will not be decided by the doctor we are sending and paying for.  It will be decided on what are the gaps missing. But paying them is a responsibility of county governments,”

He added that when county governments pay the problem is that some of the students take years to study hence the county governments have to replace that person.

“But I think that is a matter we can discuss at (IBEC) Intergovernmental Budget and Economic Council between the two levels of government. This is above my paycheck. The person who deals with IBEC resources and how to balance the resources which are shared between the two levels is not the Minister for Health, is the Deputy President and the Chair of the Council,”said Duale

The government is also working on a national needs assessment to establish the number and type of health workers required in each county and facility.

The assessment is expected to guide the equitable distribution of specialised professionals across the country, ensuring counties receive staff in proportion to their populations and health needs.

The State Department also highlighted decent working conditions and productivity as key pillars of health workforce development, noting that unemployment among trained professionals, faculty shortages, attrition and migration continue to affect the sector.