The DIAKONIA World Federation is organised into three regions: DIAKONIA Region of Africa Europe (DRAE), DIAKONIA of the Americas and Caribbean (DOTAC) and DIAKONIA Asia Pacific (DAP).

Every fourth year a world assembly is held in one of the Regions. These assemblies consist of delegates from the member associations and communities, the Executive Committee, and anyone interested in DIAKONIA. 

Along with business sessions and regional gatherings, worship, Bible studies, lectures, small group discussion, workshops, singing and celebrating are important elements of these gatherings.

The delegates elect the president of the World Federation and the members of the executive committee who are nominated by the member associations. The executive committee is the management board. The executive committee meets annually to take care of the business of DIAKONIA World Federation and to continue building relationships between the regions and member associations. The meetings are held in a variety of places around the world and are always connected to places where we have member associations and connections. Meetings also include field visits to local diaconal communities and associations and sites of diaconal service.