Health workers and managers planning and budgeting practices are unknown, yet they are key influencers of the processes. However, they rarely have the knowledge or participate in the process. This study investigated the relationship between health worker and managers knowledge on planning and budgeting, and participation in the county health planning and budgeting processes. Few studies have focused on assessing health worker knowledge and application in the planning and budgeting processes. This was a descriptive cross-sectional study that employed mixed-method approach using both quantitative and qualitative data. The sampling frame from which the study participants were drawn was N=2,229 as at June 2016. Semi-structured questionnaires were administered to the health workers and purposively selected health managers. The study sample comprised of n=257 health care workers in Nairobi County, while the health managers were 25. Data was coded and analysed using SPSS. Descriptive statistics were used to describe the relationships between knowledge and participation in health planning and budgeting. Logistics regression analysis was used to determine the relationship between knowledge and participation in health planning and budgeting. The findings of the study established that 47.5% of the health workers were not trained on planning, and slightly over a half 51.8% had not been trained on health budgeting. Among those trained on health budgeting only 23% (29) had been trained with the relevant budget training in relation to the PFM system, which is important for county health planning and budgeting. The study findings also established that 69.6% of the health workers were participating in the planning and budgeting higher than those that had actually been trained. Among the purposively selected health managers, 32% had been trained on budgeting. The health workers and managers shared “low satisfaction” with the

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