Abstract
This systematic review examines current trends in primary health care (PHC) regulation by examining scientific publications from 2015 to 2025. Following the PRISMA protocol and using coding methods, 17 scientific articles were systematically reviewed. The study shows that government regulation aimed at reducing social inequalities, expanding access and improving quality of services is only effective when initiatives are tailored to specific contexts, coordinated within the health system and adequately funded. Systemic, organizational and resource constraints are closely interrelated: shortages of staff and equipment increase clinical uncertainty, while administrative barriers limit the flexibility of health workers, leading to variability in the quality of care. Analysis of payment models shows that each has its advantages and disadvantages; an integrated approach adapted to the socio-economic conditions of the country is considered optimal. Moreover, social and organizational factors jointly determine the effectiveness of PHC: in countries with high inequality, critical barriers are lack of public awareness and shortage of specialists, while in developed settings, organizational mechanisms such as physician funding and nurse regulation are decisive. The results highlight the interdependence of regulation, organizational constraints, payment models and social factors.