The Mohalla Clinics (MCs) are referred to as the first line of defense in Delhi’s decentralized primary healthcare system. Launched in 2015, the MC scheme was designed to provide high-quality primary healthcare services to marginalized communities at their doorsteps. Today, the success of the scheme has resulted in 519 MCs in Delhi, catering to 16.24 million people annually. The success of the MC scheme in Delhi has led other states, such as Karnataka, Madhya Pradesh, Maharashtra, Gujarat, Jharkhand, and Punjab, to create comparable models of community-level primary healthcare services for the poor and the underserved. While the MC scheme has been successful in providing accessible and affordable primary healthcare to underserved communities in Delhi, there is scant research on how the built environment of the Mohalla Clinic influences the quality of healthcare communication between patients and healthcare staff. Therefore, this multi-sited ethnographic study used observations at 24 MCs and interviewed 35 staff in 9 MCs to gather data on the healthcare communication between patients and healthcare staff. An analysis of the data through NVivo V14 based on the six phases of thematic analysis revealed an overarching theme: challenges in healthcare communication necessitated by changes in the built environment following the subthemes: (1) challenges in visibility and audibility; (2) limited consultation time with doctors; and (3) challenges in getting information about healthcare services. Future studies will investigate how evidence-based design guidelines for the built environment of MCs can enhance the quality of the primary healthcare service through improved healthcare communication.