Thousands of healthcare workers employed under the PEPFAR United States Kenya Health Grant Programme are calling on the Ministry of Health to review their terms of service, saying they have spent years supporting Kenya's HIV response while working under insecure contracts with salaries they say do not match their responsibilities.
The workers say they have become the backbone of HIV, tuberculosis, PMTCT and comprehensive care programmes across the country. They staff HIV clinics, monitor patients, conduct follow ups, support viral suppression programmes and help health facilities meet national targets.
Yet many say they continue to work under short term contracts with little certainty about their future.
The appeal now places the spotlight on Health Cabinet Secretary Aden Duale and Principal Secretary for Medical Services Dr. Ouma Oluga, whose offices oversee national health policy and coordination with development partners supporting Kenya's health programmes.
The workers say the issue is no longer just about salaries.
It is about fairness.
Many claim they have worked continuously for years under donor funded programmes but remain on temporary contracts with limited benefits and no clear pathway into permanent employment. They say they perform duties similar to colleagues employed directly by the national and county governments but under very different terms.
According to the complainants, many healthcare workers under the programme earn salaries that are below comparable public service scales despite carrying heavy workloads in some of the country's busiest HIV treatment centres.
They argue that the uncertainty surrounding donor funded employment has created anxiety among staff, many of whom have dedicated years to strengthening Kenya's HIV response.
The workers warn that continued neglect could undermine staff morale and increase resignations at a time when Kenya continues to rely heavily on experienced healthcare professionals to sustain gains made in HIV prevention and treatment.
PEPFAR, the United States President's Emergency Plan for AIDS Relief, has invested billions of shillings in Kenya's health sector over the years and has supported HIV prevention, treatment, laboratory services, maternal health and health systems strengthening through partnerships with the Ministry of Health, county governments and implementing organizations.
Many of the affected workers say they are proud of the role they have played in those achievements. Their concern is that the people delivering these services have not received the same attention as the programmes they support.
The workers are now asking the Ministry of Health to develop a long term solution that recognizes experienced staff who have remained in service for years under donor funding.
Among the proposals they are presenting are a review of salary structures to bring them closer to public service standards, improved employment terms including leave and other benefits, and a framework that would allow experienced staff to transition into more stable positions through partnerships between the Ministry of Health, county governments and development partners.
Health sector experts have previously warned that Kenya's dependence on donor funded health workers creates uncertainty whenever external funding changes. Staff working under grants often face contract renewals, changing employers and concerns about sustainability, even after years of service.
The workers believe addressing their welfare would strengthen the country's health system by improving retention of experienced personnel and reducing staff turnover in HIV programmes.
Below is the appeal received by this publication.
Hide my identity.
I am writing on behalf of healthcare staff working under the PEPFAR United States Kenya Health Grant Programme across the country.
For many years, junior healthcare staff engaged under PEPFAR-supported contracts have served diligently in HIV, TB, PMTCT and comprehensive care programmes.
Despite years of service, most continue working under short-term contracts with salaries and working conditions that do not reflect their experience, workload or the critical role they play.
Many earn below public service scales, lack job security and have limited opportunities for career progression. This has led to low morale, staff turnover and challenges in retaining experienced healthcare workers.
We respectfully ask the Ministry of Health to review and improve the salary structure for junior staff employed under PEPFAR programmes, improve contract security and benefits, and develop a transition framework that would allow long-serving staff to be considered for better terms through the Ministry of Health and county governments.
We believe investing in frontline healthcare workers will strengthen service delivery and support the long-term sustainability of Kenya's HIV response.