People want, need and deserve streamlined access to support for their health. Mobile WACh (Mobile Solutions for Women and Children’s Health) is a unique open-source platform offering semi-automated bidirectional mobile messaging, connecting health care workers (HCWs) directly to patients via SMS, driven by patient characteristics, health data and clinic attendance. As a result, HCWs are empowered to offer real-time tailored information and support to patients in low-resource settings. The unique functionality of the Mobile WACh platform rests in the end user’s (healthcare worker’s) experience and ability to integrate mobile messaging into daily workflows and provide tailored, consistent, efficient health advice through individual and automated messages. (Figure 1) Mobile WACh harnesses the benefits of SMS messaging by bringing vital health information to people where they are and expands its reach by engaging users with SMS dialogue- asking critical questions at crucial times in order to assess the needs, challenges and health of babies, mothers and HIV patients. With appropriately timed and targeted messaging, patients are prompted to communicate concerns and questions in real-time through efficient bidirectional communication with trained HCWs which allows for swift connection to care and triage of potentially acute conditions (Figure 1). Mobile WACh also manages tracking of patients’ clinical care to promote attendance and retention in care. Current SMS systems provide information and visit reminders but our human centered design approach to a direct communication conduit between HCWs and patients optimizes patient support and work flow efficiencies.