In Kenya, the promulgation of the Constitution on August 27th 2010 ushered in a new era in the country’s governance system: devolution. The health sector is one of the functions devolved as clearly stipulated in the fourth schedule of the Constitution. The objective of this study therefore, was to investigate the drivers influencing delivery of decentralized health services in Wajir County. The specific objectives of the study include; establishing the influence of leadership and governance, county health policy, public participation and resources distribution on delivery of decentralized health services in Kenya. The target population was 661,941 according to the 2009 National Population and Housing Census. The sample size composed of 150 stakeholders in the health sector randomly selected across the County. Both quantitative and qualitative methods of data analysis were used. The tools used for data collection include: interview schedule and the use of questionnaire .The study established that all study variables (leadership and governance, resources distribution, public participation and accountability) had a significant influence on quality of health services delivery as shown by Beta coefficients of (0.461) (0.497) (0.486) and (0.446) respectively. The study also revealed a strong positive correlation between all study variables. The study revealed that devolution led to better resource utilization and operational efficiency in delivery of health services compared with a centralized system.