As spending on health rises in developing countries, are all groups benefiting? National Health Accounts (NHA) help answer this question, showing what health funds are buying, and the burden on households that pay out-of-pocket (OOP). This evidence is critical for allocation of resources and for initiation of financial risk protection mechanisms. 1. Introduction: Governments and stakeholders are always interested to know how much is being spent on health, who is paying for it, at which service providers and for what services. NHA is an internationally accepted framework for tracking the flow of funds in a health system that has been implemented in over 100 low- and middle-income countries (27 of them in Africa). The Panel first presents the NHA framework (the first presenter), and then each presenter illustrates use of NHA findings for enhancing equity in five countries. 2. Malawi: Between the fiscal year 2002 and 2006, total health expenditure in Malawi increased 39%, with per capita health expenditure growing from US$15 to US$25. However, Malawi had not achieved health outcomes comparable to countries spending the same or less. Also, in relative terms the government’s share declined by 40 percent, while donor contributions increased to 51%. A recent benefit-incidence analysis reveals inequities by regions, income groups, age, and gender. Malawi is moving to results-based financing to improve equity and performance. 3. Egypt: Egypt‘s four NHAs from 1995-2009show that household spending has increased 20%, while the government share decreased by 8%. The first NHA stimulated the Health Sector Reform Program in the late 1990s to expand primary health care. Similarly, the second NHA influenced the launch of the Family Health Fund to reduce OOP spending. The minister used the third NHA to advocate for more comprehensive health insurance. Finally, the most recent NHA is being used by a new government to address the declining equity. 4. Ethiopia: Ethiopia’s four NHAs between 1995/96 and 2007/08 showed low but increasing per capita spending ($4.9, $6.5, $7.1and $16.1, respectively), with OOP accounting for 37% of the total in 2007/08. The NHA results have been vital for health sector planning, health financing reforms (e.g. revenue retention at facility level, initiation of community-based health insurance), and budget negotiation resulting in increasing government funding for primary health care. 5. Kenya: Kenya has conducted four rounds of NHA between 1997-2010. The 1997 and 2001/02 NHA, which showed households accounted for over 50% of total health spending, led to a 30% increase in government budget allocation for health in 2003/4. To reduce household OOP, Kenya also initiated procurement of a three-month kit, Essential Medicines and Medical Supplies for Rural Health Facilities, channeling of operational directly to health facilities, and mobilizing donors to hire health workers to rural areas. User fees were standardized. These efforts contributed to a reduced financial burden on households, from 51% in 2001/2 to 30% in 2009/10. 6. Botswana: Botswana conducted NHA covering six fiscal years (2000/01, 2001/02 and 2002/03 in round one, and 2007/08, 2008/09, and 2009/10 in round 2). Total health expenditure has grown 30 percent since 2007/08, reaching US$444.66 per capita, one of the highest in the region. Government consistently accounted about 70 percent of total health spending. The Government needs to focus on efficiency and equity in resource allocation between levels of care, geographic areas, functions, gender, and other characteristics of beneficiaries.