Community Health Centres: Board Governance and Stakeholder Relations During Service Expansion

Despite a significant amount of literature on primary health care, little is understood about primary health care expansion. The current study examines community health centre (CHC) board governance during a period of expansion. Participants (board members) were identified through the publically available board slate and sent an introductory e-mail. Six of the twelve identified board members agreed to an in-person interview. Discourse analysis identified several aspects of governance requiring enhancement for future expansions. Study 1 focused on internal board processes and relations while study 2 focused on external stakeholder relations. Study 1 findings identified internal processes such as lack of decision support tools, low availability of documentation, and unevaluated historical decision making processes as expansion barriers. Study 2 findings identified poorly defined relationships, lack of stakeholder engagement, and poor conflict management as expansion barriers. Suggestions are made to address each of these barriers through adjustments to governance practices.