Since the launch of the National Essential Public Health Services Program in 2009, China's primary public health system has undergone a structural transformation from a focus on "building foundations and ensuring equitable access" to one centered on "improving quality and promoting population health". From the perspectives of policy evolution and public governance, this study systematically reviewed the fifteen-year development of the program (2009-2024), with a focus on its policy trajectory, institutional development, implementation outcomes, and future directions. The results showed that, over the past fifteen years, China had progressively established an institutional framework characterized by strong government leadership, stable fiscal support, and implementation through primary health care institutions. Notable progress had been made in the formalization of the system, sustained growth in public financing, expansion of service packages, transformation of primary care delivery models, and strengthening of digital governance capacity. These developments had collectively contributed to the establishment of a primary public health service network that covered the entire population across the life course. At the implementation level, key services—including electronic health records, chronic disease management, maternal and child health services, elderly health management, and the national immunization program—had been continuously strengthened. Service coverage and the level of standardized management had improved substantially, contributing to enhanced equity, strengthened primary care capacity, and improved public experience and perceived benefits of health services. Despite these achievements, several challenges remained, including regional disparities, shortages in the primary health workforce, performance evaluation systems that continue to emphasize process indicators, and limited interoperability among health information systems. Looking ahead, it is essential to further strengthen fiscal investment and performance-based incentive mechanisms, refine the design of service packages, promote integration between medical care and public health, and advance digital governance. These efforts will help improve the quality of primary public health services and strengthen health governance capacity, thereby providing institutional support for the Healthy China strategy and the achievement of universal health coverage.

自2009年启动国家基本公共卫生服务项目以来，我国基层公共卫生服务体系经历了从"夯基础、保均等"向"提质量、促健康"的制度性转型。本文从政策演进与公共治理视角出发，系统梳理国家基本公共卫生服务十五年（2009—2024年）的发展历程、制度建设、实施效果及未来发展方向。结果发现，十五年来我国基本公共卫生服务逐步形成以政府主导、财政保障和基层实施为核心的制度体系，在制度法定化、财政投入稳定增长、服务体系不断扩展、基层服务模式转型以及信息化治理能力提升等方面取得显著进展，基本构建起覆盖全人群、贯穿全生命周期的基层公共卫生服务网络。在制度实施层面，居民电子健康档案、慢性病健康管理、妇幼与老年人健康管理、免疫规划等重点服务持续推进，服务覆盖率与规范管理水平显著提高，服务公平性改善、基层服务能力增强以及居民健康获得感提高。然而，基本公共卫生服务在区域发展差异、基层卫生人力资源不足、绩效评价偏重过程指标以及信息系统互联互通不足等方面仍面临一定挑战。未来，应进一步强化财政投入与绩效激励机制，完善服务包设计，推动医防协同与数字化治理，持续提升基层公共卫生服务质量与健康治理能力，为推进健康中国建设和实现全民健康覆盖提供制度支撑。