The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) has issued a 21-day strike notice targeting doctors working in 17 counties, raising fresh concerns over the state of healthcare services in Kenya. The announcement signals growing dissatisfaction among medical practitioners over unresolved employment issues, working conditions and the implementation of agreements between doctors and county governments.

The strike notice puts county health departments on notice as the union pushes for urgent engagement with the relevant authorities. If the dispute is not resolved within the notice period, patients could experience disruptions in services at public hospitals and other healthcare facilities in the affected counties.Speaking on Wednesday, November 4, 2026, KMPDU Secretary General Dr Davji Atellah announced that the union had issued a 21-day strike notice to the affected county governments.

According to the union, the decision followed a compliance assessment conducted by its National Advisory Council during a meeting held on October 16, 2026. The assessment examined the implementation of doctors' salary adjustments across all 47 county governments.

The union established that 17 counties had failed to implement the agreed basic salary adjustments, despite commitments made by county administrations and the availability of funds intended to facilitate the changes.

Atellah said the salary adjustments were supposed to take effect in July 2026. However, doctors working in the affected counties had not received the agreed changes in their basic salaries.The strike notice targets county governments whose implementation of the agreed salary adjustments remains outstanding.

Media reports have publicly named the following affected counties:

Murang'a

Nyandarua

Nyeri

Kirinyaga

Kiambu

Lamu

Taita Taveta

Tana River

Machakos

Makueni

Laikipia

Narok

Kajiado

Isiolo

Meru

VihigaThe adjustments are connected to the 2017–2021 Collective Bargaining Agreement (CBA), together with the return-to-work formula negotiated after the nationwide doctors' strike in 2024.

The return-to-work agreement was signed on May 8, 2024, and subsequently adopted as a court order. It provided a framework for resolving outstanding disagreements between doctors and government authorities.

KMPDU maintains that the commitments made during those negotiations must be respected by both levels of government.

The union argues that doctors should not continue waiting for salary improvements that have already been agreed upon. It also insists that the implementation process should not be treated as a new negotiation because the relevant commitments have already been established.Council of Governors Had Earlier Committed to Implementation

The Council of Governors (CoG) is also at the centre of the unfolding dispute because county governments are responsible for employing and managing doctors in county health facilities.

According to KMPDU, a meeting was held between the union and the Council of Governors on July 22, 2026, to discuss the implementation of the agreed salary adjustments.

During the discussions, county representatives reportedly reaffirmed their commitment to implementing the changes.

The union further says the Council of Governors confirmed that all 47 counties had received the financial allocations required to facilitate the salary adjustments.

KMPDU maintains that the funds were released through the 2025/2026 and 2026/2027 financial years.KMPDU Rules Out Further Negotiations With Non-Compliant Counties

One of the strongest messages from the union's announcement is its position that the affected county governments should not expect another round of negotiations over the already agreed salary adjustments.

Atellah maintained that the issue is not about introducing fresh demands but implementing commitments that were reached through established labour agreements.

The union believes that further meetings without concrete action would only prolong the dispute and leave doctors waiting for payments that should already have been reflected in their salaries.

Doctors are responsible for providing essential services to millions of Kenyans, and the union believes their employment rights should be protected to ensure they can perform their duties effectively.

The salary dispute comes at a time when KMPDU is also pursuing negotiations for a new 2025–2029 Collective Bargaining Agreement with the national government and county administrations.

The new CBA negotiations are a separate process from the outstanding salary adjustments that have triggered the latest strike notice. KMPDU has indicated that it wants the new agreement concluded by December 2026. The November 25 deadline now places the affected county governments under pressure to address the dispute before doctors withdraw their services.

County governments will be expected to examine their payroll systems, establish why the agreed salary changes have not been implemented and ensure that the outstanding payments are addressed.

The Council of Governors may also face renewed pressure to coordinate a response among the affected administrations.

For KMPDU, the most important issue is ensuring that doctors receive the salary adjustments that were agreed upon rather than allowing the dispute to continue.

The coming days will therefore be important in determining whether the affected counties will comply or whether the country will witness another round of industrial action in the health sector.

The decision by KMPDU to issue a 21-day strike notice to 17 county governments marks another major development in Kenya's ongoing doctors' labour dispute. Secretary General Dr Davji Atellah announced the notice on November 4, giving the affected administrations until November 25, 2026, to implement the outstanding basic salary adjustments. The union maintains that the adjustments were already agreed upon and that funds had been allocated to facilitate their implementation. With the deadline approaching, county governments face pressure to resolve the disagreement and prevent disruptions in public hospitals. Whether the threatened strike will happen now depends on the actions taken by the affected administrations during the notice period.