When People Leave, Data Leaves Too: The Hidden Cost of Institutional Memory Loss in Public Health

In public health, we talk a lot about data - collecting it, analysing it, visualising it. But there’s another kind of data that rarely makes it into reports or dashboards: the knowledge that lives inside people.

It’s the “why” behind a decision, the story behind a number, the informal understanding of how a programme really works. And too often, that information disappears the moment someone leaves an organisation.

Every public health project, from vaccination drives to health surveys, runs on more than written plans and Excel sheets. It runs on human understanding: who the key community contacts are, which district officer is actually responsive, what messaging worked in one area but failed in another. This is what we call tacit knowledge - experience, relationships and insight that can’t easily be documented. When staff move to another job, retire or are transferred (as often happens in government systems), that knowledge walks out the door with them. What’s left behind are files, guidelines, and data but not the context needed to make sense of them.

Unlike private companies, public health organisations deal with complex social systems. Progress depends not just on technology or infrastructure but on trust, relationships and local knowledge.

For example:

• A community health officer might know why one village resists vaccination - a reason not captured in survey forms.

• A data manager might understand how to clean and interpret local records that have inconsistencies.

• A field worker may know which local leader’s endorsement actually changes behaviour.

When these people leave and their experience isn’t captured, new staff have to start from zero - rebuilding relationships, repeating mistakes and relearning what others already knew. This not only wastes time and money, but slows progress in areas where public health can’t afford delays.

The problem grows when there’s little communication between programmes. Different departments often hold information in silos, maternal health here, TB there, data systems elsewhere, with no shared platform to pass on lessons or decisions. Even within a single district, staff turnover can erase institutional memory. A project that worked brilliantly under one officer might fail under the next simply because no one told them how it worked.

We assume that as long as the data is saved, the knowledge is safe. But that’s rarely true. A spreadsheet can tell you what happened, it rarely tells you why. Without the right documentation and communication culture, data becomes disconnected from its real-world meaning. Health systems end up rich in numbers but poor in understanding. And when a project is evaluated years later, reviewers find incomplete records, inconsistent indicators, and no living memory of why certain choices were made.

How to Stop Losing Institutional Memory

Here’s how public health organisations can keep knowledge alive even when people move on:

1. Create Knowledge Repositories:
   Store not just reports, but meeting notes, reflections and key learnings. Even short “knowledge memos” can help future teams understand decisions.

2. Document Informal Lessons:
   Encourage staff to record what didn’t work, not just successes. Field diaries, internal blogs or digital logs can preserve real insight.

3. Handover Protocols:
   Make proper handovers a mandatory step during staff transitions. Not just returning laptops and files but transferring relationships, contact lists and process notes.

4. Mentorship and Overlap:
   Allow overlapping time between outgoing and incoming staff whenever possible. A few shared weeks can save months of confusion later.

5. Invest in Institutional Culture:
   Knowledge sharing should be part of performance and leadership goals not an afterthought. Recognise staff who contribute to collective learning.