A Grassroots Approach to Humanitarian Aid

An aid worker distributes rice to Haitians in Port-au-Prince following a 7.0 magnitude earthquake in January 2010. Image: Photo by Sophia Paris/MINUSTAH via Getty Images

After a devastating earthquake struck Haiti in January 2010, international aid flooded the impoverished country. Much of the funding was funneled through non-governmental organizations (NGOs) providing medical care, supplying food and clean drinking water, and rebuilding homes.

Haiti is often referred to as the "NGO Republic," with thousands of organizations providing an estimated 80 percent of the country's basic services. But the abundance of NGOs and extensive investments have failed to meet the needs of the Haitian people in building up local sustainable infrastructure, and likely contributed to the country's ongoing and urgent crises of violence and displacement.

Why were so many NGOs ineffective following the earthquake? One key factor: a mismatch between donor and organizational priorities and the needs of Haitians-for instance, jobs rebuilding homes going to international workers instead of locals, or changes to the health system that strayed from community norms.

These challenges facing Haiti became clear to members of the Applied Global Public Health Initiative, a student-run research lab at NYU School of Global Public Health that collaborates with NGOs to find innovative solutions to public health problems.

As a result of their collaboration with an NGO in Haiti, Noble and a team of fellow MPH students grew interested in the concept of "downward accountability"-the extent to which organizations "do right" by the communities they aim to serve, rather than solely answering to their donors via reports and audits.

With the guidance of NYU School of Global Public Health professors Emmanuel Peprah and Chris Dickey, students from the Applied Global Public Health Initiative and the Implementing Sustainable Evidence-based interventions through Engagement (ISEE) lab evaluated downward accountability in NGOs-including the effectiveness of different approaches and practical solutions for implementation. Their findings, published in the journal PLOS One, found that many NGO practices "rely heavily on surface-level participation that does not adequately deliver accountability," notes Noble, who led the analysis and is the study's first author.

"In the shifting landscape of humanitarian aid, a critical question persists: Do NGOs truly add value and meaningfully address the concerns of the communities they are meant to serve? If the answer is no-due to a persistent lack of downward accountability-then it is foreseeable that more countries will begin to question, regulate, or even restrict the operations of these organizations," said Peprah, an associate professor of global and environmental health at NYU School of Global Public Health.

NYU News spoke with members of the research team about how NGOs providing humanitarian aid can better empower and meet the needs of local communities.

Based on your research, what are some ways that NGOs can be accountable to the people they help?

Our research found that mechanisms grounded in local knowledge, adapted to specific cultural and political contexts, and backed by organizational commitment are more likely to succeed. At its core, downward accountability is about shifting power, ensuring that communities are not passive recipients of aid-but active participants in shaping it.

What factors get in the way of accountability?

There are also power asymmetries and competing priorities at play. Affected populations may not give NGOs feedback due to fear of losing aid or believing it is not within their rights to complain.

Organizations may believe they have responded to feedback based on their own Westernized standards, but if the community has differing expectations and standards, it can result in unmet needs and ineffective aid.

Your study describes misalignment of community needs and donor priorities. What does this look like?

In both cases, this misalignment led to ineffective resource allocation and intervention strategies for each crisis, exacerbating negative impacts in affected communities.

The focus on donor-driven outcomes, which often emphasizes quick results or quantifiable metrics, led to a lack of engagement with communities who had different, context-specific needs. It's clear that when community priorities and voices are not at the center of the response, trust between NGOs and donors erodes and shifts the perspective away from community ownership and sustainable outcomes.

Why is it important for NGOs to tailor downward accountability mechanisms to local cultural and social contexts?

It's not just about translating information into a local language. It's about understanding who gets to speak in community settings, what trust looks like, and how power operates. If NGOs don't take those dynamics into account, even the most well-intentioned accountability efforts end up feeling extractive or even performative.

When accountability mechanisms are truly tailored to the local context, they not only work better-they build lasting relationships. And in my experience, that kind of trust is essential, especially in resource-constrained settings where every intervention needs to count.

The inherent strength of individuals working together to achieve a unified vision within a community setting, supported by NGO personnel who honor the social and cultural nuances of that community, sets the foundation for a transparent and trusting relationship.

What do you hope NGOs take away from your research?