Power and Possibility in the Bill & Melinda Gates Foundation Funding for Global Maternal & Child Health

Anna L Koons, The University of Texas School of Public Health


The Bill and Melinda Gates Foundation has become one of the foremost single sources of global maternal and child health (MCH) funding in recent decades. Even as this field is recognized as critical to achieving global policy outcomes, such as in the United Nations’ Sustainable Development Goals, MCH remains a neglected funding area by more traditional global public health entities. Meanwhile, the Gates have made global MCH a central priority of their Foundation. The question of what exactly the Gates Foundation’s impact has been, and whether that influence has been beneficial to the field, was explored through a narrative review, analysis of its funding flows as compared to all global sources of MCH funding from 2000-2017, and examination of its publicly available evaluation policies and methodology. The Gates Foundation’s power as both an agenda-setting leader and a source of funding is borne out by existing evidence, especially in the field of global child health. Endorsing a set of common evaluation indicators for MCH, and a way to share those results publicly, presents an opportunity for the Gates Foundation to pull the field forward in transparency and effectiveness for improving global MCH. As an extraordinarily public-facing but ultimately privately-run institution, the Gates Foundation inhabits a unique space in which it frequently garners either disapproval or commendation for its work in MCH. This binary critical approach ignores the potential for this large foundation to influence what partnerships can achieve for global MCH. Having the Gates Foundation pull stakeholders toward transparent accountability and support for health systems while global policymakers push for clear standards could catalyze faster progress on persistent MCH problems. The extraordinary influence the Gates Foundation has on global MCH holds the potential for effective work to save mothers and children around the world.

Subject Area

Public health|Public policy

Recommended Citation

Koons, Anna L, "Power and Possibility in the Bill & Melinda Gates Foundation Funding for Global Maternal & Child Health" (2018). Texas Medical Center Dissertations (via ProQuest). AAI10928524.