The total fertility rate in Tanzania has remained nearly constant over the last twenty years at 6.3 children per woman. This high level of fertility has led to rapid population growth and compromises efforts by the government to improve the well being of Tanzanians. Despite efforts of the National Family Planning Program to increase modern contraceptive prevalence from less than 10 percent to 25 percent by 1993, data from the 1992 Demographic and Health Survey (DHS) reveal that prevalence remains low at 5.9 percent. Improving the quality of and accessibility to family planning services is one potential means to raise prevalence rates and lower fertility. To what extent do quality and access impact the decision to use a modern method of contraception and ultimately lower fertility levels for women in Tanzania? Using the Tanzania Demographic and Health Survey data, the study analyzes the impact of health facility characteristics and pharmacies as determinants of contraceptive use and fertility.