The governance dimension of primary care system is simply summarised as the vision and direction of health policy exerting influence through advocacy, regulation, and data collection and usage. The major areas of PHC governance were identified and categorized under five (5) domains vis-a-vis (Aiken et al., 2011):
Domain 1: Clinical Services
Activities under clinical services include services rendered to individual clients and/or families in both clinic and home / community settings, including treatment, prevention and early detection, as well as rehabilitation, recovery, and clinical support (Kalra et al., 2021).
Domain 2: Health Promotion
Activities under health promotion include non-clinical measures aimed at improving the health of individuals and households in communities as a whole. Key activities in this domain involve (a) building healthy public policies that provide appropriate health information and education to rural dwellers (b) encouraging community development approaches that emphasise community agency and ownership (c) and orienting health services towards health promotion (Bidassie et al., 2014).
Domain 3: Corporate Services/Infrastructure
This domain concentrates on activities that support provision of health services (Longest et al., 2000), particularly by hiring adequate number of well-trained staff. Other areas of interest under corporate services/infrastructure are integration of information technology (IT), efficient financial management systems, infrastructure development, adoption of systems for quality improvement across the facilities, as well as healthcare administration, management and leadership (Blank & Valdmanis., 2015; Agarwal et al., 2017).
Domain 4: Advocacy, Policy/Planning, Knowledge/Research
Domain 4 emphasizes the need for health advocacy on behalf of individual clients. Issues analysed may be at the local or regional levels and focus areas include change management, investment in research and development (R&D), and integration of advanced healthcare technologies for enhancing health service delivery. Under this PHC domain, individuals are encouraged to participate in research projects and policy/planning processes at all levels of government (Shi et al., 2002; Starfield et al., 2005a; Koppel et al., 2013).
Domain 5: Community Engagement, Control & Cultural Safety
Domain 5 focuses on ethical values and approaches to PHC services that ensure (a) cultural safety throughout the organisation, (b) improved relationship with host communities through engagement of individual clients and families, (c) delivery of health services based on customised healthcare plan, and (d) community participation in priority settings. Another major focus area is the strengthening structures of community control and governance (Aiken et al., 2011).