Aim 1: Technology overview: Studies that demonstrate the impacts of mHealth interventions too often have evaluated technologies that are made 'from scratch' and as a result are not robust enough to merit widespread replication [48, 74]. By partnering with a well-established non-profit mHealth organization, Medic Mobile (http://medicmobile.org/), and integrating with their existing software platform, open-source community and current efforts to integrate with existing health information systems (HIS) throughout sub-Saharan Africa, our team and proposed intervention are well positioned to scale up and sustain any promising results. Since 2008, Medic Mobile has been a leader in the global mHealth community [75-77], equipping more than 13,500 health workers serving over 8 million people across 23 countries. The Mobile Medic Toolkit is an Android-based application that supports texting in any language and works with or without internet connectivity on basic phones, smartphones, tablets, and computers [78]. The existing, well-proven, app-based Toolkit that will be the basis for 2wT provides an automated and prioritized list of upcoming tasks, guiding health worker through actions (e.g., response waiting, referral). The Toolkit provides real-time progress indicators such as texting delivery rates and response rates. Data from mobile users are replicated to Medic Mobile web app and analytics tools for real-time response. The platform is highly configurable, currently supporting evidence-backed workflows and program implementation related to ensuring safe deliveries [79], tracking tuberculosis patients [80], boosting immunization rates [81] and monitoring stocks of essential medicines [82]. These adaptable tools are free, open-source, and developed using human-centered design with input from people delivering care in the hardest-to-reach communities. While this technology has never been used in a VMMC program and requires adaptation of the clinical content, the existing 2wT software toolkit already contains the robust messaging features discussed in this proposal (Figure 2). The software adaptation process to alter and test alternative clinical content and the local specifications requires little additional software development. The adaptation process will be completed by co-investigator, Holeman, with additional technical and training support provided by Nairobi-based technical experts.