Barriers to Utilization of Primary Healthcare Services: A Systematic Review of Experiences in Ten Selected Countries Publisher Pubmed



Mostafavi H ; Mohamadi E ; Mohammadi A ; Bakhtiari A ; Jafarzadeh J ; Olyaeemanesh A ; Takian A
Source: International Journal of Public Health Published:2026

Abstract

Objectives – This study aimed to identify the reasons for inadequate use of PHC services to mitigate the barriers to utilization of PHC services in Saudi Arabia, Oman, Turkiye, Pakistan, Iraq, Thailand, China, India, Egypt, and Iran. Methods – This is a systematic review that synthesized the findings of original studies focused on the barriers to the utilization of PHC services. We searched the MEDLINE, Scopus, and Google Scholar databases from February 1, 2000, to December 29, 2023, in English. We conducted content analysis facilitated by MAXQDA-10 software drawn upon Levesque’s framework. Results – The screening of articles was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The initial search retrieved 1, 613 results, of which we included 29 studies. In terms of methodology, 17 studies used quantitative methods, eight had qualitative approaches, and the remaining studies utilized mixed or other methods. Among the five groups of identified barriers, ability to perceive, ability to reach, and ability to pay were found to be noteworthy barriers that should be considered by health policymakers. Conclusion – Although the main barriers to inadequate use of PHC are related to people, raising awareness about the need for PHC, improving literacy through understandable training, and establishing mobile facilities in remote areas are appropriate strategies for increasing the use of PHC services. Copyright © 2026 Mostafavi, Mohamadi, Mohammadi, Bakhtiari, Jafarzadeh, Olyaeemanesh and Takian.