Planned Parenthood Federation of America (PPFA), or Planned Parenthood, is a nonprofit organization that provides reproductive health services both in the United States and globally. A member association of the International Planned Parenthood Federation (IPPF), PPFA has its roots in Brooklyn, New York, where Margaret Sanger opened the first birth control clinic in the U.S. in 1916. Sanger founded the American Birth Control League in 1921, which changed its name to Planned Parenthood in 1942. Planned Parenthood consists of 159 medical and non-medical affiliates, which operate over 650 health clinics in the U.S. It partners with organizations in 12 countries globally. The organization directly provides a variety of reproductive health services and sexual education, contributes to research in reproductive technology, and performs advocacy work aimed at protecting and expanding reproductive rights. PPFA is the largest single provider of reproductive health services, including abortion, in the U.S. In their 2014 Annual Report, PPFA reported seeing over 2.5 million patients in over 4 million clinical visits and performing a total of nearly 9.5 million discrete services including 324,000 abortions. Its combined annual revenue is US$1.3 billion, including approximately US$530 million in government funding such as Medicaid reimbursements. Throughout its history, PPFA and its member clinics have experienced support, controversy, protests, and violent attacks.