Police have fired tear gas to disperse hundreds of doctors striking in the Kenyan capital Nairobi.
The medics were demanding the government honour a 2013 deal to increase salaries.
Dozens of mental health patients were said to have walked out of a hospital in Nairobi during the strike.
Officials say the action is premature and negotiations should continue.
They say doctors have defied a court order suspending the strike until the end of this month to allow for more talks.
But the Kenya Medical Practitioners Pharmacists and Dentists’ Union (KMPDU) said it had run out of patience after government commitments failed to materialize.
“We have had lots and lots of diplomacy, and lots and lots of dialogue. Dialogue has to come to an end,” union chairman Samuel Oroko said.
About 5,000 medical staff in more than 2,000 public hospitals stopped working at midnight on Sunday.
Source:BBC