The Global Alliance for Improved Nutrition (GAIN) and Wellspring Development designed and hosted a series of in-person and online consultations with partners of the Dutch Ministry of Foreign Affairs to examine challenges in improving the quality of diets of population groups living in rural areas of Low and Lower-Middle Income countries. These groups still largely consume nutrient-inadequate, even unhealthy, diets and face heavy burdens of malnutrition. This fifth paper, out of six, looks specifically at the challenges in managing complex programme comprising multiple components, as well as the roles played by external actors in programme success and how best to manage this. The aim of the discussions was to elaborate on the definitions of coordination and orchestration, gather examples where these have been done successfully and to understan