The Trump administration is changing how and where the U.S. government delivers health aid around the world, breaking decades of practice to bypass nongovernmental organizations and prioritize the Western Hemisphere and Asia Pacific regions over Africa, U.S. officials said Thursday. Secretary of State Marco Rubio’s new approach aims to end “a culture of dependency among recipient countries,” he said in a document announcing the change. In the coming months, the State Department plans to negotiate new bilateral agreements with countries to deliver health aid in ways that cut out nongovernmental organizations. For decades, U.S. officials assessed that those groups had more technical expertise than partner governments, so they helped manage and deliver health aid in many nations. The new strategy also veers away from decades of focus on Africa, where many nations rely on the United States government to help with H.I.V.