Health unions have given counties seven days' notice to ensure salaries are paid and other statutory deductions remitted.

The unions on Tuesday noted that failure to do so will see healthcare workers in affected counties fail to report to work.

They include the Kenya Medical Practitioners Pharmacists and Dentists Union, the Kenya Union of Clinical Officers, the Kenya National Union of Nurses among others.

"More than 40 counties are yet to either pay healthcare workers or remit statutory deductions making our members miss out on the very services they are offering," KMPDU SG Dr Davji Attellah said.

They have noted that a few counties that have managed to pay salaries have reported having arrangements with banks for overdrafts and loans.

Atellah noted that 10 years since health was devolved, no proper framework has been established to ensure healthcare services function efficiently and effectively.

"Kenyans have witnessed numerous blame games between the national and county governments concerning finances, drug and equipment acquisition and employment of healthcare workers," he said.

This, the unions, said, has led to the detriment of healthcare service delivery.

A cash crisis has hit counties after revelations the government is broke.

Treasury PS Chris Kiptoo told senators on late last month that the government faces acute cash flow challenges.

Kiptoo disclosed to the Senate's County Investment and Special Funds Committee that the taxman has failed to meet its revenue target, affecting several government programs including disbursement to the devolved units.

The National Treasury has been caught between a rock and a hard place as senators push for Sh407 billion allocation to counties amid cash flow challenges.

The senators, through the Finance Committee, want the Treasury to increase by Sh22 billion the current proposed allocation of Sh385 billion for the next financial year.

This would see the counties get an additional Sh37 billion from the current financial year’s Sh370 billion allocation in equitable share.