The mCDMSS (SMS text messaging–based mobile clinical decision-making support system) project aimed to develop and maintain resilient health systems in low-resource settings like Ghana by adapting technology to improve health outcomes. This innovative mHealth system utilized text messaging (SMS) to deliver standard emergency maternal and neonatal protocols via unstructured supplementary service data (USSD) upon request from healthcare providers. Implemented through a cluster randomized controlled trial (CRCT) in the Eastern Region of Ghana, the project facilitated easy access to maternal and neonatal guidelines for routine and emergency obstetric, antenatal, and neonatal care for frontline providers. Running from August 1, 2015, to July 31, 2017, the project focused on newborns and pregnant women in Ghana, using software and phone-based decision support interventions to enhance maternal and child health. The outcomes, affecting between 3,000 to 10,000 individuals, included improved adherence to neonatal healthcare protocols and insights into frontline health worker information needs, supported by quantitative evidence.