Contraceptive access has both public and private benefits. While an average of over 170 million
dollars were spent on contraceptives procured for developing countries each year since 2000, an
ongoing debate in the empirical literature is whether increases in contraceptive access and supply
drive declines in fertility (UNFPA 2014). This paper studies the supply and fertility relationship in
Zambia, a high-fertility developing country. Donors and NGOs supply over 80 percent of total
contraceptives to Zambia, most of which are provided for free at government clinics (DELIVER
2015). In 2008, the country started receiving higher quantity and frequency of contraceptive
donations (UNFPA 2014). Donations may have increased for two reasons: donors and the Zambian
government started a systematic method of forecasting contraceptive need on December 2007, and
the Mexico City Policy was lifted in January 2009. In this paper, I investigate whether a large change
in quantity and frequency of donated contraceptives affected fertility, using available data on
contraceptive donations to Zambia, and birth records from the 2007 and 2013 Demographic and
Health Surveys. I also use a difference-in-difference framework to estimate the fertility effects of a
supply chain improvement program that started in 2011, and was designed to ensure more regularity
of contraceptive supply. Results show a 6 percent decline in fertility during the post-2007 period of
high contraceptive supply, after controlling for demographic characteristics and regional fixed
effects. There is no evidence of the supply chain improvement program leading to significant fertility
declines during the post-2007 period. I supplement my analysis with information from interviews
with Zambian supply chain administrators and experts, and 61 qualitative interviews of users and
non-users of contraceptives in Zambia.