Access to public health services remains a major challenge for health systems worldwide, particularly in contexts marked by resource limitations, inequities, and increasing pressures on healthcare management. Strengthening service delivery requires a deeper understanding of how health systems respond to population needs, how users perceive the quality and availability of care, and how organizational factors influence performance. This Special Issue addresses these themes by examining access, governance, and service organization across diverse settings, with special attention to contexts where structural constraints shape health outcomes. The studies included in this Special Issue offer concise and valuable contributions to these discussions. Research on Brazil’s Unified Health System highlights differences in user experiences across regions, while findings from eight African countries illuminate job satisfaction among primary care workers and its implications for workforce stability. Additional contributions explore the integration of mental health services into HIV and tuberculosis programs in South Africa, the role of digital health tools in the management of chronic diseases, and persistent barriers to accessing essential treatments such as radiotherapy. We hope this collection supports researchers, practitioners, and policymakers committed to advancing more equitable, efficient, and people-centered health systems.
