The Conceptual and Institutional Framework (CIF) establishes the broad governance and management structures of the Partnership for Maternal, Newborn and Child Health (PMNCH). Early experience with the operationalization and implementation of the Framework reveals a number of possible gaps and inadequate specificity which may hamper decision-making within the Partnership and open the Partnership to a variety of risks. The Secretariat engaged a consultant to prepare this report which makes a number of recommendations to strengthen the governance of the Partnership over the immediate to medium-term. The consultancy involved a review of the CIF, the Memorandum of Understanding of Agreement between PNMCH and World Health Organization (WHO) (the host of the Secretariat), minutes of Transition Team and interim Steering Committee meetings, the draft Institutional and Partnership work plans, discussions with Secretariat staff and the Steering Committee chairs, and draws on lessons from other Global Health Partnerships.