1. GRADE‐CERQual evidence profile.

Summary of review finding	Studies contributing to the review finding	Methodological limitations	Coherence	Adequacy	Relevance	GRADE‐CERQual assessment of confidence in the evidence	Explanation of GRADE‐CERQual assessment
1. Infrastructural issues, such as challenges in charging phones, uploading and transmitting data, and loss of data due to poor access to electricity and poor or non‐existent internet connectivity were identified as key barriers to implementation.	Asiimwe 2011; Atnafu 2017; Biemba 2017; Negandhi 2016; Shieshia 2014; Stanton 2016; USAID 2016	Serious concerns, because 6 studies had serious methodological limitations (insufficient evidence to support findings), and one study had minor methodologic limitations	No, or very minor concerns about coherence	No, or very minor concerns about adequacy	No, or very minor concerns about relevance	Moderate confidence	Reduced due to methodological limitations, as all source material did not include empirical data.
2. Concern was expressed that digital stock notification systems used at the facility level could not mitigate several, broader health system problems, including an underlying lack of stock at the national or district level, and a mismatch between national ordering routines and local needs.	Chandani 2017; Githinji 2013; Hara 2017; Mikkelsen‐Lopez 2014	Serious concerns, because 3 studies had serious methodological limitations (insufficient evidence to support findings), and one study had minor methodologic limitations	No, or very minor concerns about coherence	Minor concerns about adequacy, as 3 studies refer to the same intervention administered in different settings	No, or very minor concerns about relevance	Low confidence	Reduced due to methodological limitations, and concerns about adequacy, as conclusions are based on few studies.
3. Programmes could benefit from strong partnerships, such as with local authorities; with local telecommunications companies; with technical system providers; and with non‐governmental organizations (NGOs).	WHO 2013	Serious concerns, because one study had serious methodological limitations (insufficient evidence to support findings, and unclear description of the intervention)	No, or very minor concerns about coherence	Concerns about adequacy, as only one study contributed to the finding	No, or very minor concerns about relevance	Very low confidence	Reduced due to methodological limitation, as source material did not include empirical data, and concerns about adequacy, as conclusions are based on one study with thin data
4. The availability and use of data on stock levels at all levels of the health system allowed health care officials to respond to anticipated shortages.	Asiimwe 2011; Barron 2016; Biemba 2017; Shieshia 2014; Stanton 2016	Serious concerns, because 4 studies had serious methodological limitations (insufficient evidence to support findings), and one study had minor methodologic limitations	Concerns about coherence due to contradictory findings	No, or very minor concerns about adequacy	No, or very minor concerns about relevance	Low confidence	Reduced due to methodological limitations, and concerns about coherence of the data.
5. Supportive supervision and responsive management played an important role in effective adoption of a digital system.	Asiimwe 2011; Barrington 2010; Chandani 2017; Negandhi 2016; Shieshia 2014	Serious concerns, because 4 studies had serious methodological limitations (insufficient evidence to support findings), and one study had minor methodologic limitations	No, or very minor concerns about coherence	No, or very minor concerns about adequacy	No, or very minor concerns about relevance	Moderate confidence	Reduced due to concerns about methodological limitations
6. The extent to which health workers are familiar with smartphones and are given adequate training in using the digital system, influences the adoption of the system.	Asiimwe 2011; Barrington 2010; Githinji 2013; Negandhi 2016; Shieshia 2014; Stanton 2016	Serious concerns, because 5 studies had serious methodological limitations (insufficient evidence to support findings), and one study had minor methodologic limitations	No, or very minor concerns about coherence	No, or very minor concerns about adequacy	No, or very minor concerns about relevance	Moderate confidence	Reduced due to concerns about methodological limitations.
7. The availability of technical programming expertise for the initial development and ongoing maintenance of the digital system is an important implementation factor.	Asiimwe 2011; Biemba 2017; USAID 2016	Serious concerns, as 3 studies had serious methodological limitations (insufficient evidence to support findings)	No, or very minor concerns about coherence	Concerns about adequacy, as only 3 studies contributed to the finding, and the presented data are sparse.	No, or very minor concerns about relevance	Low confidence	Reduced due to concerns about methodological limitations and adequacy, as conclusions are based on three studies with thin data.
8. Incentives, such as receiving phone talk‐time credit, to improve adoption and use of the digital system are valuable.	Barrington 2010	Serious concerns, because 1 study had serious methodological limitations (insufficient evidence to support findings)	No, or very minor concerns about coherence	Concerns about adequacy, as only 1 study contributed to the finding	No, or very minor concerns about relevance	Low confidence	Due to methodological limitations and concerns about adequacy, as conclusions are based on few studies.
9. User‐friendly systems, built with user participation with easy‐to‐use interfaces were considered important to implementation.	Namisango 2016; Negandhi 2016; Shieshia 2014	Serious concerns, because 2 studies had serious methodological limitations (insufficient evidence to support findings), and one study had minor methodologic limitations	No, or very minor concerns about coherence	No, or very minor concerns about adequacy	No, or very minor concerns about relevance	Moderate confidence	Reduced due to concerns about methodological limitations.
10. The use of basic mobile phones or personal phones by health workers reduced challenges with data coverage and expense, and supported easier adoption of the intervention due to familiarity with the phones.	Barrington 2010; Stanton 2016	Serious concerns, because 2 studies had serious methodological limitations (insufficient evidence to support findings)	No, or very minor concerns about coherence	Concerns about adequacy, as only 2 studies contributed to the finding	No, or very minor concerns about relevance	Low confidence	Reduced due to methodological limitations, and concerns about adequacy, as conclusions are based on few studies.
11. Software features, such as ability to capture images, map geographic features, support two‐way communication, toll‐free text messaging, and interoperability were considered important.	Barrington 2010; Negandhi 2016; Shieshia 2014	Serious concerns, because 2 studies had serious methodological limitations (insufficient evidence to support findings), and one study had minor methodologic limitations	No, or very minor concerns about coherence	Minor concerns about adequacy, due to few studies and the relevant data are sparse.	No, or very minor concerns about relevance	Low confidence	Due to concerns about methodological limitations, and concerns about adequacy, as conclusions are based on few studies.
12. Dashboard design and data visualisation played important roles in effective implementation. Managers should have access to data in an easy‐to‐use format, such as an interactive dashboard.	Negandhi 2016; Shieshia 2014; USAID 2016	Serious concerns, because 2 studies had serious methodological limitations (insufficient evidence to support findings), and one study had minor methodologic limitations	No, or very minor concerns about coherence	No, or very minor concerns about adequacy	No, or very minor concerns about relevance	Moderate confidence	Reduced due to concerns about methodological limitations.