The government owed doctors and Community Health Promoters (CHPs) Sh4 billion in unpaid obligations as of June 30, putting strain on healthcare services across the country, a new report has revealed.
A CHP is trained member of the community who works as a link between the community and formal health facilities.
Analysis by the Parliamentary Budget Office (PBO) — which advises lawmakers on economic and budget affairs — shows that the national government owes more than Sh2 billion to the 107,831 CHPs, while an additional Sh1.8 billion is owed to county governments for doctors' salary arrears.
Out of the Sh3 billion allocated for CHPs in the 2024/25 fiscal year, only Sh786 million was disbursed, leaving a funding gap of about Sh2.2 billion.
Under the 50-50 co-funding plan between national and county governments, only four counties – Bomet, Kwale, Tharaka Nithi, and Uasin Gishu z- received national government contributions for CHPs.
On the county side, just 14 counties managed to pay their share, and even these payments remain irregular and in arrears.
“The CHPs project is severely underfunded by both sponsors, with only Sh786 million disbursed out of the Sh3 billion allocated to the project in the financial year 2024/25. Currently supporting 107,831 CHPs, the project is co-funded by the national government and county governments on a 50:50 basis,” the PBO said in a disclosure dated November 2025.
It not clear if part of the debt to doctors and CHPs has been cleared. The Parliamentary office said that reports by the Controller of Budget, however, showed that only four counties received the national government contribution for CHPs in the financial year 2024/25.
“To motivate and stabilise the health workforce, the national government has allocated Sh1.759 billion for the settlement of financial year 2024/25 salary arrears owed to county government health workers, to be transferred through the County Government Additional Allocations Act, 2025 (CGAAA),” PBO said.
The doctors' salary arrears stem from the Return-to-Work Formula agreement with the Kenya Medical Practitioners, Pharmacists and Dentists Union, covering Phase II doctors' salary obligations for the 2024/25 financial year.
While the County Governments Additional Allocations Act 2025 was designed to release these funds, its delayed passage in June 2025 has left counties financially stranded. Counties remain legally obligated to pay their doctors, but are doing so without the promised cash backing.
The severity of the crisis was demonstrated by Kiambu County's 150-day doctors' strike that ended in October. The standoff, which began on May 26, was finally resolved through Council of Governors mediation, with an agreement that Kiambu would pay one month's salary alongside October salaries immediately, while the remaining three months' arrears would be cleared in the 2026/27 financial year.
