How are Skype out and other VOIP calls routed?

Can you answer sotires’s question about VoIP?:

How does the call get from the public Internet onto the telephone network? Does Skype (and the other VOIP operators) own equipment in each country to provide the interface? Where is it situated, in each telephone exchange, or centrally?
Mali, the question concerned calls that go from the internet to land phones.

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