I think countries who give out aid not give the money straight to the govt.
For eg. My country India still receives a lot of aid not only from other countries but also from different orgs like the Bill and Melinda Gates foundation...... These orgs and govt aid programs tie up with local NGO(Non-Govt Orgs) that already have an understanding of what needs to be done in certain societies. The only thing that stops them from doing it is the absence of money.
Now if a huge country like mine can make a change then I'm sure others can too.