Technical assistance (TA) in the health sector has been defined and interpreted in myriad ways. TA is generally characterized as short- or long-term support provided by one institution to another on a specific topic or topics. The support can be provided via training, seminars, or the transfer of knowledge through collaboration between institutions. TA is typically financed and designed by funding organizations like bilateral or multilateral agencies or private philanthropies. This type of TA aims to improve the effectiveness and efficiency of health systems and organizations. TA processes typically involve multiple actors and operate within a political, legal, and financial context. In this paper, we focus on external TA as a mechanism for health-focused technical and foreign assistance. This type of TA which is a structural mechanism through which a large portion of foreign assistance is delivered, is one of the four functions of the global health architecture framework as described by the Bill & Melinda Gates Foundation (BMGF), the others being agenda setting, finance, data, and monitoring.