Contraception in Discourse and Development: A Case Study of the Bill and Melinda Gates Foundation’s Role in Global Family Planning

This study examines the Bill and Melinda Gates Foundation’s (BMGF) role in global family planning by interrogating how the organization structures its relationships with bilateral and multilateral donors, development NGOs, national governments, and private sector corporations. I analyzed how the BMGF’s digital messages fit into broader development discourse and how the organization is situated in the larger global family planning community. I further examined how the BMGF addresses local culture, social norms, gender, and equality on its website and in its social media messages. The BMGF’s role is global family planning is complex, so I used multiple theoretical frameworks to guide my qualitative analysis: critical political economy of communication (CPEC), development communication (devcom), feminist frameworks, and public health campaign scholarship. I conducted a document and critical discourse analysis on BMGF financial disclosures, annual reports, committed grants, website material, and Twitter posts using a grounded theory approach. The case study is limited to materials from 2014 to 2018 because 2014 was the year the foundation shifted to an empowerment model that placed women and girls at the center of its development goals. The BMGF structures its relationships largely through philanthropic grants. It calls grantees partners, though the relationships do not represent equal power dynamics between both organizations. The BMGF is a leader in global family planning because it allocates more money than any other organization in the community, creating a top-down organizational structure that allows the foundation ultimate control over global family planning projects and discourse. BMGF digital messages about family planning do not address local culture and social norms, instead opting for generic descriptions of women and girls as a homogenized group characterized by shared oppression. The foundation website’s family planning section only briefly mentions gender equality and its social media messages only mention inequalities. This case study contributes to scholarship in CPEC and devcom and to feminist frameworks in critical-cultural healthcare