**4.5 What are the guiding approaches, rules, or procedures to improve NIMART training and implementation? (the principle/s)**

The guiding principle refers to the rule, technique, protocol, and routine governing the activities to achieve the terminus [14]. According to the Donabedian SPO model [13], the recipient, agent, and principles that guide NIMART training and implementation are referred to as the structure. Providing quality training, mentoring, support, and compliance to policies, guidelines, SOPs, and protocols are the guiding principles that facilitate achieving patient and framework outcomes. Again, monitoring, reporting, and evaluation facilitate the identification of gaps, signs of danger & success in arriving at the terminus. Another principle to facilitate and influence implementation is the involvement of all internal and external stakeholders, which includes district clinical specialist teams (DCST), facilitators, RTC managers, the province and district leadership, developmental partners, HEI, SANC, and HWSETA in implementation.
