The counties’ health workforce shrank 26 percent in the financial year 2025/26, leaving the devolved governments scrambling to replace tens of thousands of frontline workers as donor-funded programmes wind down.
New disclosures show that healthcare workforce fell to 98,907 from 149,447 the previous year, a loss of 50,540 workers, according to the 2026 State of Devolution Address.
Most of the drop, about 41,000 workers, is attributed to the termination of US government programmes, including 28,600 frontline healthcare workers.
The figures exclude workers in national referral hospitals, as well as those in faith-based and private facilities.
The overall reduction also reflects the transfer of Jaramogi Oginga Odinga Teaching and Referral Hospital from the county to the national government.
“For the period under review, the total health workforce across all 47 counties was 98,907, excluding those in national referral, faith-based, and private hospitals. This presents a 26 percent decline,” said the Council of Governors in the report.
The staffing shock followed the US decision in January 2025 to pause foreign development assistance for 90 days and review its programmes. The move initially disrupted PEPFAR-supported services in Kenya, with UNAids reporting that health workers in affected facilities were instructed to stop work, while staff of implementing partners were sent on leave.
Although a subsequent waiver allowed lifesaving HIV treatment to continue, the disruption persisted. By March 2025, UNAids reported that doctors, nurses, laboratory technologists, pharmacists and community health workers supported by US programmes had been affected, alongside disruptions to some HIV treatment and community services.
The cuts were later fixed through a July 2025 US rescissions law that cancelled Sh1.2 trillion previously approved global foreign aid, while USAid was dismantled.
The changes marked a significant shift in the way US health assistance is delivered, including its long-standing support for Kenya’s HIV response.
In December 2025, Kenya and the US signed a five-year Health Framework for Cooperation covering HIV and other health priorities, signalling a move towards a new model of health cooperation and greater co-investment between the two countries.
The shift in US health financing now leaves counties facing a greater share of the cost of maintaining the workforce. County health allocations increased by 11.7 percent to about Sh154.58 billion in 2025/26, from Sh137.57 billion the previous year.
The Council of Governors said counties have responded by recruiting clinical officers, laboratory technicians, and nurses to fill the gaps. In the year under review, 498 doctors were released for postgraduate training, while 40 percent of the 681 health workers who had been studying in the previous year returned to work.
