The study aims to review Flexibility, Responsiveness and Decentralisation and Local Relevance in P135-III Management and Implementation. The study, conducted from April to July 2010 included review and assessment of 7 inter-related management approaches with the purpose to suggest strategic solutions to enhanced effects, responsiveness and local relevance of P135 interventions in its next phase. The 7 approached are; 1. Result based management and incentive systems 2. Evidence-based resource allocation 3. Demand driven approach 4. Regional approach 5. Participation mechanisms for engagement beneficiaries and other local stakeholders in P135 decision-making 6. Coordination mechanisms between and within components, and horizontally and vertically between agencies 7. Delegation of regulatory authority to enhance relevance of regulations to local context.