The study examined the relationship between good governance practices and the performance outcomes of selected health centres in Kayunga District, Uganda. Specifically, the study assessed the influence of community participation, accountability mechanisms, and resource availability on health centre performance. The study was guided by the Principal–Agent Theory and Institutional Theory. The Principal–Agent Theory was applied to explain how accountability mechanisms such as supervision, transparency, and reporting aligned the actions of health workers (agents) with the expectations of government and communities (principals). Institutional Theory was used to explain how adherence to established governance norms, rules, and procedures shaped organizational behavior and performance within public health facilities. The study adopted a descriptive cross-sectional research design and employed a mixed-methods approach. Quantitative data were collected using structured questionnaires administered to health workers, health centre managers, and members of health unit management committees, while qualitative data were obtained through key informant interviews. A sample of 114 respondents was selected using stratified and simple random sampling techniques. Data were analyzed using SPSS, employing descriptive statistics, Pearson correlation, and regression analysis, while qualitative data were analyzed thematically. Findings on the first objective revealed a strong positive relationship between community participation and health centre performance (r = 0.716, p < 0.01). Community involvement in planning, feedback meetings, and decision-making significantly improved service utilization, patient satisfaction, and responsiveness of health services. Regarding the second objective, the study found a significant positive relationship between accountability mechanisms and performance outcomes (r = 0.684, p < 0.01). Facilities with clear reporting systems, regular audits, and transparent financial practices recorded better service delivery, improved staff discipline, and enhanced public trust. For the third objective, results indicated a positive and significant relationship between resource availability and health centre performance (r = 0.702, p < 0.01). Adequate staffing levels, consistent availability of essential medicines, and functional infrastructure were found to significantlyenhance outpatient attendance, maternal health service utilization, and immunization coverage. The study concluded that good governance practices played a critical role in enhancing the performance of health centres in Kayunga District. Community participation, accountability, and resource availability were mutually reinforcing governance dimensions that significantly influenced service delivery outcomes. Strengthening governance structures was therefore essential for improving efficiency, effectiveness, and equity in public health service provision. The study recommended that the Ministry of Health and district authorities strengthen community participation platforms, institutionalize accountability mechanisms through routine audits and transparent reporting, and ensure adequate allocation and maintenance of essential health resources.