**4.4 What are the support systems to strengthen NIMART training and implementation? (dynamics)**

The dynamics refer to the sources of power or energy among the activities [14]. According to Donabedien [13], this refers to the process that facilitates the implementation of the CF, including the guiding principles. Provision of motivation, acknowledgement, and recognition of NIMART nurses for rendering services under difficult conditions substantially influences and facilitates implementation. Intrinsic and extrinsic recognition is necessary to motivate and enhance performance. This would invariably boost their self-esteem, build confidence, and improve their sense of responsibility and feeling worthy to the department. Again, the Department of Health should meet NIMART nurses' needs and deal with their frustrations. Furthermore, avoiding negative criticism and blame–punishment feedback would greatly influence successful implementation.
