Ministers should give cash aid directly to the impoverished African state of Malawi, MSPs have been urged.
Judith Robertson, the Scottish head of relief charity Oxfam, said the approach could dramatically improve healthcare and education standards.
Her comments come as a study by Holyrood's European committee on international aid is published.
The current and previous Scottish governments have formed a special relationship with Malawi.
Rural support
Ms Robertson told the committee that the country, one of the poorest in the world, had only one nurse for every 3,500 people and thousands of unfilled nursing jobs.
She argued direct budget support was an effective way of getting help where it was needed.
"One option, and one Oxfam would like the Scottish Government to explore, is to provide direct budget support to the Malawian Government, specifically targeted at healthcare and education for the poorest, especially those in rural areas," she said.
Increasing nurses salaries, Ms Robertson told MSPs, would reward "heroic" staff, while support could be given to ensure the Malawi government was held to account for the way the money was spent.
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