The dissertation examines the health conditions in Nakuru county over the years 2013-2017. By examining this important case we assess trends in disease prevalence, effectiveness and efficiency of health services and general health care.We use data from the District Health Infomation System(DHIS2). Missing data for some years in the system is one of the major problems that we faced. Due to the improved efficiency and effectiveness since devolution of health care, the health conditions of Nakuru county residents continue to improve. With adequate supply of medical services from the county government, the county health will continue to improve.