**4.2 Who is the recipient of HIV management after NIMART training? The recipients**

A recipient is a person or thing receiving action from the agent [14]. In this framework, the recipient is any health care worker receiving NIMART training. These can be PNs, facilitators, student nurses, nurse educators, or programme managers. The agent should provide comprehensive quality training to improve the skills, competence, and confidence of the NIMART nurse in providing quality care to the patients and facilitators and educators to transfer the skills to the students. In addition, the patients indirectly benefit from the NIMART training as they receive care from the NIMART nurse equally.

#### **4.3 In what context is the NIMART training implemented? (the setting)**

The context refers to resources, activities, and environments which enable or facilitate the implementation of the NIMART conceptual framework [14]. A combination of organizational resources and a conducive, safe and comfortable environment in the district primary health care system can facilitate implementation. Having adequate, independent, experienced, skilled human resources for health (HRH) with positive attitudes toward PLWH and HIV programmes facilitates robust implementation. Again, the development of a standard integrated NIMART curriculum and effective interactive strategies that stimulate critical thinking and facilitate the integration of theory

and practice can influence implementation. Moreover, the provision of NIMART/HIV management pre-service training to student nurses, continuous professional development (CPD), and in-service training on HIV changes can facilitate NIMART implementation. This also includes the availability of good communication and relationship skills, compliance to HIV/TB and PHC policies, guidelines, protocols, and standard operating procedures (SOPs) to facilitate implementation. In addition, treating patients and nurses with respect and attending to their concerns or challenges can also facilitate implementation. Furthermore, maintaining the physical infrastructure of the PHC facilities, having enough space, re-organizing the facility in line with the ideal clinic integrated clinical services management (ICSM) standards, and reducing waiting times can facilitate implementation and quality. Prioritizing the PHC in budget planning is necessary to deal with the overt challenges influencing implementation. Provincial and district management team support, flexibility, coaching, and supervision are necessary to influence and facilitate discipline and meaningful implementation.
