The study investigated the effect of accountability mechanisms on performance outcomes at selected health centres in Kayunga District, Central Uganda. The research examined how financial accountability, administrative accountability, clinical accountability, and community accountability mechanisms influenced performance outcomes including service delivery quality, patient satisfaction, resource utilization efficiency, and health outcomes. A descriptive crosssectional survey design was employed, involving 114 respondents comprising health centre managers, medical staff, administrative personnel, patients, Ministry of Health officials, local government officials, community leaders, and Board of Governors members. Data were collected through structured questionnaires and analyzed using Pearson correlation and multiple regression analysis. Results revealed a significant positive relationship between accountability mechanisms and performance outcomes (r=0.806, p