Global health partnerships (GHPs) have proliferated in the global health sector, yet few studies have investigated how low- and middle-income countries (LMICs) engage in partnership governance that set forth the priorities, guidance, and programs for members to collaborate on addressing specific global health issues. This dissertation reveals how GHPs serve as global governance platforms for managing specific global health issues by producing and transferring global guidance agreed upon by stakeholder representatives and leveraging managerial and enforcement tools to generate collective action towards achieving global health goals. It examines the roles of LMIC member states in the formulation of and adherence to global guidance in Gavi and the Partnership for Maternal, Newborn, and Child Health. This study finds some support that greater engagement in GHP governance leads to greater adherence to GHP guidance among LMIC member states, and that employing both managerial and enforcement tools is more effective in securing greater adherence to GHP guidance compared to using only type of tool. This study contributes to literature that seeks to understand LMIC cooperation in international development and their adherence to global health agreements by demonstrating the importance of including LMIC states in the global governance of issues that affect them. The findings also offer further insights into how GHPs wield influence over national health systems in LMICs through their guidance and management of international development resources.