This paper examines the need for better coordination of external resources through a discourse on the effectiveness of aid and good government. The review of key issues, allowing increased attention to aid coordination in the health sector, presents the first section. The second section describes, assesses, and compares the strengths and weaknesses of the dominant mechanisms found to be utilized, to coordinate health sector aid in the case studies. The case studies include the low-income, high aid-dependent countries of Bangladesh, Cambodia, Mozambique, and Zambia. Four factors were clear in the analysis. First, coordination mechanisms in many countries have been introduced as a part of an incremental process after trying out several approaches. Second, some instruments function largely for consultation, predominantly coordinating inputs; while, others are more directive and operational. Third, many of the mechanisms have not excelled, although judging the effectiveness or impact of aid coordination was difficult. Finally, the paper ends by suggesting that experience and analysis of different coordination mechanisms has shifted the effect of the policy environment on coordination of aid inputs per se to the management of processes, through which domestic and external resources are deployed.