The Primary Health Centre (PHC) presents a unique link between rural health-seekers and health service providers. PHCs play an essential role in bridging the healthcare delivery gap and provide the first point of contact for health awareness, remedial, preventive, and curative care at subsidized cost. India has been a pioneer in bringing the concept of primary healthcare to the world and Bhore committee’s recommendations for healthcare delivery system defined the role of primary health centres in rural settings. The concept of “health for all” was coined in India much before the inception of WHO in 1948 and the Declaration of Alma-Ata in 1978. The evolutionary approaches for improving healthcare services through different policy initiatives have shaped PHCs in the country in the last 75 years but the interventions can be observed as a top-down approach and due to systemic complexities, lacks meeting the core objective of primary health care. The research tries to identify the relationship between the policy interventions and the systemic gaps with emerging needs in individual PHCs contexts. It observes the empathetic review of individual PHCs largely missing in the interventions, leading to a complex outcome of healthcare delivery, asymmetric structures of PHCs, and increasing disengagement with users. The research aims to explore the functioning of primary healthcare in India through its policy interventions and reflectively map the present-day challenges of healthcare delivery in the rural context of PHCs.