Nursing vacancies will henceforth be filled on contract basis, the national and county governments resolved Monday at a summit on issues affecting service delivery amid perennial strikes.
The meeting, held at the State Lodge in Sagana, noted the need for lasting solutions to the strikes that leave patients paying highly for treatment at private facilities.
In a joint statement on Monday, Health Cabinet Secretary Sicily Kariuki and Council of Governors chair Wycliffe Oparanya (Kakamega) announced eight resolutions aimed at improving services.
Key among them, according to the statement, was "that any vacancies for recruitment of nurses arising from normal attrition in both levels of government be filled on contract terms".
Natural attrition is the circumstance under which employees leave an organisation for reasons that are considered normal, such as resigning and retiring.
This resolution is a big blow to nurses as those on contract have limited benefits and cannot join unions.
Their job security is also at stake, as it is not guaranteed that their contracts will be renewed.
To implement the decision, the Public Service Commission (PSC) was asked to develop a Standardized Contract Framework for engaging the health workers on the terms and conditions of this new arrangement.
The Salaries and Remuneration Commission will be consulted, Ms Kariuki and Mr Oparanya also said.
At the gathering dubbed the '7th Session of the National and County Government Coordinating Summit', officials also agreed on disciplinary proceedings for nurses who did not end their industrial action and report to work on February 15 as ordered.
Nurses yet again went on strike on February 4 in a push for, among others, better salaries, uniform and nursing service allowances and promotions.
A court suspended the strike for 60 days but they remained adamant, with Kenya National Union of Nurses Secretary-General Seth Panyako saying the only way out was the full implementation of their return-to-work formula.
Some did not report to work even with an order by President Uhuru Kenyatta, who directed the Health ministry and county governments to fire those who defied the directive.
As a result, Mr Panyako was charged with contempt of court but let off with a warning.
In 2017, nurses downed their tools for five months while doctors stayed away from work for 100 days in a push for similar demands, actions which cost the lives of many patients.
The summit also addressed negotiations between the governments and the health workers, saying they should continue in line with a court order and that all stakeholders must show commitment.
"The Ministry of Health and governors [will] be briefed regularly and updated on the progress made, with a view to ensuring a harmonised position by both levels of government is sustained," the communique stated.
The Labour ministry will continue to perform its role of steering matters on workers' welfare in health and other sectors, Ms Kariuki and Mr Oparanya said.
The officials added that should the 60-day court-ordered conciliation period end without solutions, the national and county governments will take measures to urgently fill gaps in service provision.
Another resolution was for the Labour ministry to begin to review the law to identify gaps in service provision and for the PSC to develop guidelines on the management of human resources in the sector.
The goal of the summit was to "enhance consultation, cooperation and coordination in the search for sustainable solutions to current and future challenges, based on the provisions of the Constitution, legislation and principles of collective responsibility to respond decisively to prevent, manage and resolve industrial disputes".
As such, it was also decided that statutory and third party remittances will continue in line with the law and that the two levels of government will be consistent with consultations in order not to have differing views on matters regarding nurses' welfare.