The objective of this study was to identify and characterize contracting models that have existed in the Zambian health sector and their consequences on access to health care. The study was aimed at assessing the extent to which the identified contracting models have been successful in achieving their intended goals and at determining their potential to be scaled up to the entire health sector, including the private sector. The study used both qualitative and quantitative approaches. The data were collected from both primary and secondary sources. A selected number of providers and policymakers were interviewed using a semi-structured questionnaire. Secondary data were collected using a structured questionnaire. The study reveals that contracting-in and contracting-out are prevalent in Zambia. Contracting-in is seen where the government is providing health service to the people on a wide scale. Different levels of the referral system within the public health sector contract with each other through the concept known as “purchase of beds.” Contracting-out is evidenced by the relationship existing between government and the faith-based organizations and not-for- profit nongovernmental organizations where the latter are providing health services to the people on behalf of the government. The survey results show that contracting-in and contracting-out to the private not-for-profit providers has significantly grown over the years.