Health Development Initiative strives to improve both the quality and accessibility of healthcare for all Rwandans through advocacy, coalition building, capacity building, outreach, and training of beneficiaries and duty bearers. HDI was founded in 2005 by a dedicated group of Rwandan physicians working in health facilities and communities across the country. This diverse group of health professionals was united by a shared commitment to improve the health of disadvantaged communities within and outside of the healthcare system. When HDI was established, the founders knew that Rwanda’s most vulnerable populations were not being heard by their communities, duty bearers, and policy makers. Thus we began by listening and getting to know the people that HDI would strive to serve in order to learn how to design the programs and why those programs were so critical.