Background and Aims: The primary healthcare (PHC) system is a comprehensive, equitable, and efficient approach to supporting health and social well-being by offering prevention, treatment, and rehabilitation services close to living environments. The PHC system in Iraq is currently facing issues that limit its effectiveness and efficiency. This research aims to discover strategies to enhance the PHC system in Iraq. Methods: We conducted a systematic search for articles on initiatives aimed at enhancing the PHC system, covering the period from 1980 to June 2024, using eight databases and Google Scholar. We included articles that met the criteria and analyzed them using the framework analysis approach with RevMan 5.3 software. Results: A total of 18,705 articles were extracted. After removing duplicates and items without full text, 15,971 studies remained for title and abstract review, of which 14,175 were removed. Finally, 18 research articles related to PHC strengthening were used. Data collection methods included checking databases (12 studies), interviews (6 studies), focus groups (3 studies), questionnaires, and archival data (15 studies). The majority of research (44.45%) was conducted in Baghdad. Conclusion: In the context of Society 5.0, smart technology’s practical applications in healthcare aim to enhance decision-making, patient care, and service delivery. Smart technologies can help nurses make clinical decisions in complex care situations and streamline procedures like paperwork. When rebuilding and strengthening the PHC system, addressing the historical, social, cultural, and economic variables is important.