The world's population has more than doubled over the last 40 years—from 2.5 billion to 5.3 billion. This rapid growth has been accompanied by massive increases in the number of people living in poverty and mounting pressure on resources of all kinds, as families and societies struggle to meet basic human needs for food, shelter, education, and health care.

Since the 1950s, rapid population growth and its implications have been topics of continuing, often contentious, public debate. But there has also emerged, gradually, a deepening understanding of the causes and consequences of such growth. Efforts to address these issues have evolved from an early focus on trying to convince, if not coerce, people to limit their fertility to a much broader approach emphasizing reproductive health.

The Ford Foundation's work in the population field has also evolved—from early work in the 1950s that helped establish demography as an independent academic study, to supporting research on the reproductive sciences and contraceptive development, to promoting the use of family-planning services and helping women gain the power necessary to improve their status and influence in society.

Our experience working with governments, nongovernmental organizations, researchers, and policy makers in many countries suggests that people across the world recognize the need for a comprehensive approach to population issues. They have come to appreciate the importance of enabling women and men to gain greater control over their lives and of providing them with the knowledge and means to make informed choices about family size. And the best way to do that is to start with an inquiry into how women and their partners define their own reproductive needs and priorities.

It is clear from listening to men and women in such an inquiry that there are many kinds of reproductive health issues. Among them are access to safe and effective fertility-regulation services, adequate prenatal and neonatal care, children's survival and healthy development, and control of sexually transmitted diseases. All need attention. Improving reproductive health, broadly defined, not only bears directly on population growth but also represents an important challenge and need in its own right.

We have come to realize that success in addressing reproductive health concerns requires a better understanding of the social, economic, and cultural factors that shape behavior and attitudes. Among the most important of these factors are women's social status and access to education and economic resources; the quality of health services; and practices and beliefs regarding sexuality, fertility, and childbearing. It follows, then, that developing solutions to reproductive health problems requires the participation