The burden of poor maternal, neonatal and child health (MNCH) remains unacceptably high in many developing member countries (DMCs). To understand the barriers facing households in accessing MNCH care, the ADB technical assistance project RETA-6515 analyzed data from routine national household expenditure surveys in six DMCs: Bangladesh, Cambodia, the Lao People's Democratic Republic (Lao PDR),Pakistan, Papua New Guinea, and Timor-Leste. The findings reveal not only the rich evidence base available in these surveys, but also show how healthcare costs, quality, and physical barriers play differing roles in different countries in preventing access, and how families are often impoverished by accessing needed care.