Background: Comprehensive primary healthcare through Ayushman Bharat- Health and Wellness Centres (HWCs) was initiated by Government of India in 2018. The present study explores performance variations among HWCs, and the reasons for the variations from a provider’s perspective. Methods: A sequential mixed methods study was conducted in Punjab state between April to September 2021. The quantitative facility assessments of 8 HWCs was followed by 16 in-depth interviews with the community health officers (CHOs) and Auxiliary midwives (ANMs) to understand their perceptions about service delivery. This was supplemented with physical observations, and desk review of administrative orders. A descriptive data analyses was carried out to identify variations in resources between the high and low-performing HWCs. A framework analyses was applied on qualitative data using the ‘Capacity, Opportunity, Motivation, Behaviour’ model. Results: There was significant difference in infrastructure at the high and low-performing HWCs, but the quantity of human resources was similar. The categories identified from the in-depth interviews that affected work performance were capacity, communication, opportunity, and motivation. Capacity was contingent on trainings, work experience, self-belief, role clarity, and level of communication between cadres, while supportive supervision and incentives affected the work motivation. Conclusion: Understanding and sharing of roles was poor in low performing HWCs. Appropriate facility designs considering the role of staff, improved communication at all levels of health system, and reappraisal of financial policies linked to HWCs are important for performance. There is a requirement to build management capacities in all HWCs to achieve work efficiency.