OFH operates under a public-private partnership that links the private, franchised OFH clinic network with the public health system and national health insurance. In partnership with the Ministry of Health, OFH has operated in Rwanda since 2012; OFH currently operates 125 health posts across 14 Districts and has provided services to nearly 2 million Rwandans who previously had limited access to healthcare. OFH health posts participate in the national health insurance program, ensuring the affordability of care for the most vulnerable Rwandans. Patients with insurance pay only a small co-payment for each visit, while those lacking insurance can pay a moderate fee out-of-pocket. OFH does not build clinics, but uses facilities provided by local government partners. Clinics are owned and operated by qualified local nurses, a majority of whom are female, who receive training in financial management and operations as well as clinical skills, enabling them to become successful entrepreneurs. As small business owners, the nurses are motivated to provide the most critical services to their community during the most convenient hours. OFH’s primary care health posts focus on conditions that comprise the majority of illnesses in rural communities. To date, the diseases most commonly treated in OFH health posts are diarrheal disease, acute respiratory infections and malaria, which contribute more than 30% of under-five deaths in Rwanda.