{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:12:47Z","timestamp":1782360767823,"version":"3.54.5"},"reference-count":127,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"unspecified","delay-in-days":229,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prim Health Care Res Dev"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S1463423625000271_as1\">\n\t    <jats:title>Background:<\/jats:title>\n\t    <jats:p>Demographic transitions, societal changes, and evolving population health needs are placing increasing pressure on healthcare systems, necessitating ongoing reforms. Primary health care (PHC) is a foundational component of Universal Health Coverage (UHC) and sustainable health systems. Many countries have undertaken PHC reforms aimed at improving population health. This review explores the objectives, implementation mechanisms, challenges, and outcomes of these reforms.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1463423625000271_as2\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>We conducted a systematic review of studies sourced from five databases (PubMed, Scopus, Proquest, Embase, and Science Direct), applying the World Health Organization\u2019s Health Systems Framework for deductive content analysis. The PRISMA guidelines were followed to ensure transparency and rigour in summarizing the published literature.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1463423625000271_as3\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>A total of 147 types of interventions were identified, with most targeting service delivery and financing. Key reform objectives included expanding access to care, improving financing and payment systems, scaling up family physician programmes, increasing government health expenditure, leveraging private sector capacities, and strengthening the PHC workforce. These interventions resulted in expanded public health coverage, enhanced access to PHC, increased utilization of services among low-income populations, broader social insurance coverage, and improved service quality, contributing to better community health outcomes.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1463423625000271_as4\">\n\t    <jats:title>Conclusion:<\/jats:title>\n\t    <jats:p>The success of PHC reforms depends on their alignment with political, social, and cultural contexts, as well as consideration of the social determinants of health. Strong governmental support, managerial stability, decentralization, and regional capacity building are essential for sustainable implementation. Reforms should be gradual, supported by accurate forecasting, adequate and sustainable resources, and evidence-based strategies, drawing on international experiences.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s1463423625000271","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T03:43:31Z","timestamp":1755488611000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":6,"title":["Primary health care reforms: a scoping review"],"prefix":"10.1017","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9383-4631","authenticated-orcid":false,"given":"Ahmad","family":"Shirjang","sequence":"first","affiliation":[{"name":"Iran Health Insurance Organization"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5197-8437","authenticated-orcid":false,"given":"Leila","family":"Doshmangir","sequence":"additional","affiliation":[{"name":"Tabriz University of Medical Sciences"},{"name":"Tabriz University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2543-1862","authenticated-orcid":false,"given":"Mohammad","family":"Bazyar","sequence":"additional","affiliation":[{"name":"Ilam University of Medical Sciences"},{"name":"Ilam University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3906-2316","authenticated-orcid":false,"given":"Vladimir Sergeevich","family":"Gordeev","sequence":"additional","affiliation":[{"name":"London School of Hygiene & Tropical Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"key":"S1463423625000271_ref84","volume-title":"Building the Economic Case for Primary Health Care: A Scoping Review","year":"2018"},{"key":"S1463423625000271_ref14","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/dat029"},{"key":"S1463423625000271_ref94","doi-asserted-by":"publisher","DOI":"10.1590\/S0102-311X2011001000002"},{"key":"S1463423625000271_ref111","first-page":"e114","article-title":"Challenges facing China\u2019s Public health and primary health care in health care reform","volume":"2","author":"Sun","year":"2014","journal-title":"Journal of Vascular Medicine and Surgery"},{"key":"S1463423625000271_ref39","doi-asserted-by":"publisher","DOI":"10.15171\/ijhpm.2014.32"},{"key":"S1463423625000271_ref38","first-page":"129","article-title":"Revolving doors: New Zealand\u2019s health reforms","volume":"18","author":"Gauld","year":"2001","journal-title":"Social Policy Journal of New Zealand"},{"key":"S1463423625000271_ref96","first-page":"243","article-title":"The evolution of the Finnish health-care system early 19th century and onwards","volume":"3","author":"Saarivirta","year":"2012","journal-title":"International Journal of Business and Social Science"},{"key":"S1463423625000271_ref101","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-014-0609-y"},{"key":"S1463423625000271_ref115","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2019-002086"},{"key":"S1463423625000271_ref122","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2016.01.015"},{"key":"S1463423625000271_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.piro.2015.02.011"},{"key":"S1463423625000271_ref4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7261.608"},{"key":"S1463423625000271_ref12","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare4030045"},{"key":"S1463423625000271_ref90","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmy129"},{"key":"S1463423625000271_ref102","doi-asserted-by":"publisher","DOI":"10.4102\/phcfm.v8i1.1026"},{"key":"S1463423625000271_ref81","doi-asserted-by":"publisher","DOI":"10.1007\/s10198-007-0081-2"},{"key":"S1463423625000271_ref62","first-page":"42","article-title":"Health in the Islamic Republic of Iran, challenges and progresses","volume":"27","author":"Lankarani","year":"2013","journal-title":"Medical Journal of the Islamic Republic of Iran"},{"key":"S1463423625000271_ref114","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61364-1"},{"key":"S1463423625000271_ref31","first-page":"13","article-title":"Iran health system reform plan methodology","volume":"42","author":"Esmailzadeh","year":"2013","journal-title":"Iranian Journal of Public Health"},{"key":"S1463423625000271_ref98","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.985079"},{"key":"S1463423625000271_ref136","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17218040"},{"key":"S1463423625000271_ref21","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckl114"},{"key":"S1463423625000271_ref51","unstructured":"Hu, R. , Zou, H and Shen, C (2011) Health Care System Reform in China: Issues, Challenges and Options. 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