At the project level, which is the domain of NGOs, it is a tough call. The core issues are usually generic, require addressing at the national or regional level, and necessitate a longer timeframe, greater planning, and additional resources, which are not always possible by the NGO. On the other hand, it is also true that the particular problem the NGO addresses is often a symptom but not the core issue.

However, the NGO may still address, partly, if not fully, this with tactical and strategic planning at the local level in many cases.

In a palliative critical health care project, an NGO observed a high incidence of stroke patients. While a mix of physiotherapy and medicine worked for them, it was observed that the villagers did not carry out regular health check-ups and monitor blood pressure, resulting in an unchecked increase in high pressure and consequent incidence of strokes.

The core issue was the villagers’ lack of convenient access to the public healthcare system. While the NGO, at its level, could not address the same, it decided to monitor blood pressure and provide access to medicine for the same. This did not add any significant stress to their existing resources. Clearly, for the NGO, this was the core issue operating nearer home, which it can address, and their modified approach became adopting preventive palliative care approach for this segment.

An NGO providing supplementary education to young children operates in a limited number of villages. While the curricula of primary schools are fixed at the state level, where the NGO has no reach, it is considering advocating to the teachers of neighboring communities to incorporate the supplementary charts and other tools used by it into their teaching. It will not be easy.

So, a proposed set of procedures for meeting the first humanity-centered principle are:

• Seek and identify the core issues operating at the local level for the different beneficiaries of the project.
• Among the issues thus identified, select those that the NGO can attempt to address without straining its budget and timeline.
• Discuss with the project sponsor any remaining issues that the NGO cannot address with its existing resources. Explore whether the sponsor can help address these issues by providing additional resources.
• In the end, there may remain issues that can only be addressed at the global level. List them and keep them in mind.

At a project level, it is a tall order to achieve this. In some instances, the entire ecosystem may not even prove relevant, for example, for projects providing health care, nutrition, or vitamins to mothers or supplementary education to children. This issue, however, may become important for many other types of interventions.
We propose the following SOP:

• Before formulation or implementation of the project, the global impact of the proposed intervention on the ecosystem may be considered in detail
• Then, investigate to what extent these factors impact the target area or the beneficiary segments of the project and formulate the implementation plan accordingly.

We make more or less the same observations as we did on the second principle. The time factor, however, requires mention.

Most NGO projects are funded for a specific duration. So, while the long-term view may not be feasible, the implementing agency should be aware of the possibilities of future negative impacts, if any, and start incorporating corrective measures.

This becomes especially important for projects that address specific incidents at the household level — for example, critical healthcare, palliative care, or care for individuals with mental or physical disabilities and similar.

To ensure continuous refining of the implementation design so that it is truly meeting the concern of the target beneficiaries, a feedback mechanism with the beneficiary and, more importantly, the caregiver needs to be instituted.

Mainly, these projects are designed to be ‘reactive,’ and the NGO provides support and intervention to the households where the ‘incident’ has been reported. This approach is effective in large and diverse urban settlements. However, for urban slums and rural communities in developing economies, the approach needs to be proactive. To ensure this, a regular scanning mechanism needs to be established.

Therefore, the proposed operating procedure is to incorporate the following into the proposed project formulation.

• Set up a feedback mechanism that ensures flexibility in design, allowing for the addition or reformulation of parameters.
• Set up a regular community scanning process.

It may be argued that how can an NGO achieve this design goal when specific delivery objectives of products or services constrain the project? In a few cases, this argument may hold. Still, on most occasions, multiple issues will require community cooperation and concern, necessitating that these design criteria be met for the project to succeed.

In a project providing supplementary education to children in a rural community, the curriculum is designed by the NGO, the tutor is selected locally and then trained, and the community provides the classroom. The community participates with the NGO at every step. This did not happen overnight. The first village required considerable effort to overcome the trust deficit and establish the project’s value. The second village took almost the same effort and time. The third and fourth were easier, as by then, the NGO had learned better. Other villages and communities then either came forward on their own or required significantly less effort. The project is almost community-owned now.

In a project aimed at providing critical health, emotional, and medical care to the seriously ill, the initiative followed a similar trajectory. Today, the community actively participates in identifying patients for the NGO; they are trained in in-home care for patients and, in some ways, encouraged to act as partners.

In other cases, community support may be required not for demand generation, but to overcome delivery and supply constraints, such as the provision of nutrition and supplementary feeding.

Among vulnerable populations, it may not be possible to invite the community as design partners; however, the project can be designed to involve them as implementation partners.

In the above light, the suggested operating procedures are:

• Prepare advocacy and communication kits along with implementation planning
• Invite the community as a strategic partner at the local level
• Use the initial cases as a demonstration
• Proceed slowly, later accelerate