The ‘lived-in experience’ of global health: The grassroots wisdom we risk losing

Global Health has accumulated unprecedented knowledge through frameworks, indicators, guidelines, datasets and increasingly powerful digital tools. Yet one valuable resource remains remarkably underused: the lived-in experience of people who have spent decades delivering grassroots health care. This experience is more than accumulated information; it is tacit wisdom shaped by repeated encounters with patients, communities, health systems, scarcity, failure, adaptation and unintended consequences. Such wisdom reveals what actually works, what fails, why programmes succeed or falter at the last mile, and where globally developed guidance requires local adaptation. As experienced health workers retire, this unwritten knowledge risks disappearing. Listening to them is therefore both a practical necessity and a form of respect.