In many developing countries, their governments dominate the field of water resources management. Even in “participatory irrigation management” efforts, the governments play a dominant role. As these efforts are rarely based on any internally generated demand from the water users, they usually fail to create viable organizations at the local level. A similar setback can be seen in the more recent institutional reforms in Asia’s water sector, which are promoted by the donor agencies and, national and international development professionals. A survey of experiences in Asian countries shows that no country has successfully completed establishing new water sector policies and laws and river basin organizations, as prescribed. The need to improve current performance of water resources management is widely appreciated. In managing the scarce water resources, a change in attitude and approach is seen to be essential. Participatory learning and action methods conducted in a study of selected river basins in five Asian countries surfaced a distinct need for coordination at the river basin level. They also indicated a clear stakeholder preference for establishing coordinating mechanisms, by way of adapting the existing institutions, as an initial step towards greater stakeholder control of river basin management. Essentially, cost-effective and contextually appropriate institutional arrangements were preferred over the prescribed standard models, in order to meet the varying needs related to integrated water resources management.