Hrev_master Healthcare in Low-resource Settings 2024; volume 12:11941 Enhancing maternal role achievement and breastfeeding success through health belief model intervention Nurus Safaah,1,2 Esti Yunitasari,1 Budi Prasetyo,3 Mira Triharini,1 Pipit Feriani1,4 1Faculty of Nursing, Universitas Airlangga, Surabaya; 2Department of Public Health, Institut Ilmu Kesehatan Nahdlatul Ulama Tuban, Tuban; 3Faculty of Medicine, Universitas Airlangga, Surabaya; 4Faculty of Nursing, Universitas Muhammadiyah Kalimantan Timur, Samarinda, Indonesia Abstract Breastfeeding is a critical component of maternal and infant health. The study, conducted from April to June 2023, aimed to evaluate the impact of the mother’s role achievement module on breastfeeding practices among postpartum mothers in Indonesia. Sixty participants were divided into intervention and control groups in a quasi-experimental setup. The intervention group showed remarkable improvements: a 25% increase in breastfeed- ing frequency, a 15% weight gain, a 30% enhancement in proper breastfeeding technique, a 20% improvement in breast care prac- tices, and a 25% boost in nutritional intake compared to the con- trol group. Conversely, the control group showed a reduced breastfeeding frequency by approximately 20%, a 10% decrease in weight, a 35% inadequacy in breastfeeding technique, varied breast care practices, and insufficient nutritional intake, showcas- ing the disparity between the groups. Statistical analyses, includ- ing Mann-Whitney and Chi-Square tests, confirmed these signifi- cant differences, emphasizing the module’s substantial impact on breastfeeding success among postpartum mothers. In conclusion, tailored interventions based on the Health Belief Model play a pivotal role in enhancing maternal and infant health outcomes in Indonesia. This study recommends integrating similar approaches into healthcare policies to bolster breastfeeding practices among postpartum mothers, potentially improving overall maternal and infant health in the region. Introduction Breastfeeding stands as a cornerstone of infant health, recom- mended by the World Health Organization (WHO) for the first six months of life.1 However, in countries like Indonesia, exclusive breastfeeding rates often fall below optimal levels.2 Mothers encounter significant challenges in the early postpartum weeks, including issues like insufficient milk supply and sore nipples, prompting some to discontinue breastfeeding prematurely.3,4 Furthermore, uncertainties about breastfeeding’s ability to ade- quately satisfy infants’ hunger contribute to this discontinuation trend.5 Empirical evidence establishes a connection between delayed milk production in the first three postpartum days and maternal anxiety, dissatisfaction, and a shift toward formula feed- ing.6,7 The widespread belief in insufficient breast milk supply plays a substantial role in breastfeeding discontinuation.8 A moth- er’s beliefs play a crucial role in breastfeeding success, making the postpartum period pivotal in shaping maternal choices and influ- encing infant health outcomes.9 Correspondence: Nurus Safaah, Faculty of Nursing, Universitas Airlangga Campus C Mulyorejo, Surabaya, 60115, Indonesia. Tel.: +61.813.5777.5448. E-mail: nurus.safaah-2020@fkp.unair.ac.id Key words: breastfeeding; health belief model; module; mother's role achievement. Contributions: NS, study conception and design, data collection, critical revisions for important intellectual content, and manuscript writing. EY, study conception and design, study supervision, critical revisions for important intellectual content. BP, study conception and design, study supervision, critical revisions for important intellectual content. MT, study conception and design, study supervision, critical revisions for important intellectual content. PF, data collection, literature analysis, manuscript writing, and references. Conflict of interest: the authors declare no conflict of interest. Ethics approval and consent to participate: recommendations were ini- tially obtained from Airlangga University's Doctoral program, specifical- ly via the Ethics Committee for Health Research at the Faculty of Nursing, Airlangga University, which granted ethical approval under number 266-KEPK in November 2022 with one year validity period. Subsequently, permission was secured from the Tuban District Government, specifically the Investment and Integrated One-Stop Service Office (PTSP). The research was then meticulously conducted, aligning rigorously with its ethical objectives. Patient consent for publication: written informed consent was obtained for anonymized patient information to be published in this article. Funding: this research did not receive external funding. Availability of data and materials: all data generated or analyzed during this study are included in this published article. Acknowledgement: we express our gratitude to all the participants, their families, and the individuals who collected the data, as they played essential roles in contributing to this research. Received: 10 October 2023. Accepted: 1 December 2023. Early access: 11 January 2024. This work is licensed under a Creative Commons Attribution 4.0 License (by-nc 4.0). ©Copyright: the Author(s), 2024 Licensee PAGEPress, Italy Healthcare in Low-resource Settings 2024; 12:11941 doi:10.4081/hls.2024.11941 Publisher's note: all claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organi- zations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. [Healthcare in Low-resource Settings 2024;12:11941] [page 143] Non -co mmerc ial us e o nly The Health Belief Model (HBM) provides a valuable frame- work, highlighting an individual’s readiness for health-related actions based on perceived susceptibility, severity, benefits, and barriers.10 This model emphasizes cues to action and self-efficacy in decision-making, proven effective in enhancing breastfeeding knowledge and behaviors across diverse populations.11,12 Despite its effectiveness, there is still a deficit in the preparedness of preg- nant women for breastfeeding, which affects their motivation and confidence in this crucial maternal journey.13 Previous studies, such as Paramashanti et al. (2023),14 have highlighted the chal- lenges of breastfeeding discontinuation due to perceived milk sup- ply inadequacy, aligning with the issues observed in Indonesia. However, while prior research emphasizes the importance of breastfeeding and acknowledges the role of the HBM, the specific cultural, societal, and familial factors influencing breastfeeding decisions among Indonesian postpartum mothers remain less explored.15 This study addresses this gap by evaluating the impact of the “Mother’s Role Achievement Module,” guided by the HBM, on maternal role attainment and breastfeeding success in Indonesia. The novelty of this study lies in its focus on culturally sensitive interventions tailored to the Indonesian context, aiming to bridge the gap between theory and practice in nursing interven- tions. Indonesia’s cultural norms, societal pressures, familial expectations, and individual beliefs significantly shape breastfeed- ing choices, necessitating a deeper understanding to develop effec- tive interventions and policies.16 This research seeks to contribute to nursing scholarship in Asia, offering insights into determinants that influence breastfeeding choices among Indonesian postpartum mothers. Therefore, this study aimed to evaluate the impact of the “Mother’s Role Achievement Module” on breastfeeding practices among postpartum mothers in Indonesia. Materials and Methods Design This study adhered to the Transparent Reporting of Evaluations with Non-randomized Designs (TREND) guidelines and employed a quasi-experimental design—a more complex research design involving both pre-test and post-test assessments for both the intervention (treatment) group and the control group. This design involved assessing the outcomes solely after the inter- vention had been administered, with the results subsequently ana- lyzed to evaluate the effectiveness of the research. Population, sample, and sampling The study included pregnant women in their third trimester until postpartum period day 14, encompassing those within Public Health Center and Health Center regions. It involved a total of 60 respondents, evenly split between the intervention and control groups. Data collection occurred from April to June 2023, spanning three months. Sample size calculation considered a significance level of 0.05, a power level of 0.80, and pre-study proportions based on prior research or assumptions. The calculated sample size, con- sidering a 10% addition for potential dropouts, resulted in a total sample size of 30 respondents. Therefore, after accounting for the possibility of dropouts, the actual sample size obtained for this study in each group was 30 participants. Random sampling ensured fairness, and randomization was achieved through a coin flip to allocate participants. This comprehensive approach ensured the study’s credibility and meaningful conclusions. Variable The study’s dependent variable encompassed breastfeeding success and maternal role attainment among postpartum mothers in Indonesia, encapsulating various facets like early breastfeeding steps, breastfeeding frequency, infant weight gain, breastfeeding techniques, breast care, and maternal nutrition. This variable served as the focal point for gauging the impact of the intervention. On the other hand, the independent variable was represented by the intervention itself—the “Mother’s Role Achievement Module” rooted in the Health Belief Model. This intervention sought to aug- ment maternal role attainment and breastfeeding success among postpartum mothers. Meanwhile, the control group received edu- cation on breastfeeding benefits through the KIA (Maternal and Child Health) handbook during their Antenatal Care visits. Instruments and intervention The instruments, aligned with the Health Belief Model and breastfeeding guidelines, underwent pre-testing for clarity and reli- ability. Adjustments were made based on feedback from a small respondent group, ensuring validity. These instruments included a demographic tool, a Health Belief Model-based training module with standard operating procedures (SOPs), and observation sheets. The intervention, spanning four sessions, provided compre- hensive support, emphasizing respect, shared responsibility, and mutual agreement. Additional tools assessed various aspects of breastfeeding success, crucial for evaluating the intervention’s impact. This study involved two groups: the treatment group and the control group. The treatment group underwent a comprehen- sive intervention based on the Health Belief Model. It included four sessions over four weeks, covering various topics like explaining the caregiver role, demonstrating breastfeeding tech- niques, setting agreements with participants, and reinforcing key concepts. Additionally, a home visit ensured effective implementa- tion. Conversely, the control group received breastfeeding educa- tion via the KIA handbook during their routine ANC visits at the Public Health Center. Unlike the treatment group’s structured ses- sions, the control group received information solely from the hand- book without personalized support. Both groups’ progress was measured through pre-test and post-test assessments, and observa- tions of breastfeeding practices, enabling a comparative analysis of the interventions’ impacts. The treatment group experienced the structured HBM-aligned intervention, while the control group received standard educational materials during routine healthcare visits, forming the basis for comparison in evaluating the interven- tions’ effectiveness. Data collection process The inclusion criteria targeted mothers with infants who were actively engaged in breastfeeding. Additionally, respondents need- ed to demonstrate proficiency in the Indonesian language and pos- sess reading and writing skills. Exclusion criteria applied to moth- ers unable to provide breast milk due to their baby’s hospitalization or those with mental health disorders. Additionally, dropout crite- ria were established for postpartum mothers unable to complete the study before the post-test and participants who withdrew during the intervention. The study conducted pre-test and post-test assessments and observed breastfeeding practices. Instruments gauged early breast- feeding steps, frequency, infant weight gain, techniques, breast care, and maternal nutrition. The intervention spanned four ses- sions over one month. Transforming Healthcare in Low-Resource Settings: a Multidisciplinary Approach Towards Sustainable Solutions [page 144] [Healthcare in Low-resource Settings 2024;12:11941] Non -co mmerc ial us e o nly Analysis Descriptive analysis was used to explore variables without establishing relationships. Categorical data were presented through frequency distributions and percentages, while numerical data used measures like mean, median, and standard deviation. Parametric tests, such as the t-test, were employed for normally distributed data, including breastfeeding frequency, infant weight gain, and maternal nutrition. Non-parametric tests, such as the Mann-Whitney U test, were applied to variables like early breast- feeding steps, techniques, and breast care, which deviated from normal distribution. Ethical consideration In this study, ethical principles were diligently followed in accordance with TREND guidelines. Initial approval was obtained from Airlangga University’s Ethics Committee for Health Research (Approval No. 266-KEPK). Subsequent permission was secured from the Tuban District Government. The research strictly adhered to ethical objectives, including obtaining informed con- sent and implementing rigorous confidentiality measures to protect participant identities and sensitive information. Results Descriptive analysis was used to explore variables without establishing relationships. Categorical data were presented through frequency distributions and percentages, while numerical data used measures like mean, median, and standard deviation. Parametric tests, such as the t-test, were employed for normally distributed data, including breastfeeding frequency, infant weight gain, and maternal nutrition. Non-parametric tests, such as the Mann-Whitney U test, were applied to variables like early breast- feeding steps, techniques, and breast care, which deviated from normal distribution. The data from Table 1 reveals that in the experimental group, most participants had pregnancies lasting 37 weeks, possessed a high school education, and had an average age of approximately 23.20 years. In contrast, in the control group, most respondents experienced pregnancies of 37 or 38 weeks, had completed high school, and had an average age of around 23.37 years. Upon con- ducting the significance test, it is evident that the characteristics of the respondents, such as gestational age, educational background, and maternal age, resulted in p-values exceeding 0.05. Consequently, it can be inferred that there is no notable distinction in terms of gestational age, education, and maternal age between the experimental group and the control group’s respondents. The data presented in Table 2 reveals that none of the respon- dents practiced Early Initiation of Breastfeeding (EIBF) in the experimental group. However, most of these participants main- tained a regular breastfeeding frequency, observed weight gain, correctly applied breastfeeding techniques, practiced proper breast care, and had a normal level of nutritional intake. In contrast, with- in the control group, none of the respondents practiced EIBF. Furthermore, most of these participants had a reduced frequency of breastfeeding, experienced weight loss, inadequately executed breastfeeding techniques, exhibited varying levels of breast care (some performed well, while others did not), and had insufficient nutritional intake. All 60 participants, evenly distributed with 30 in the treatment group and 30 in the control group, were encompassed in each anal- ysis. Adhering to the “intention to treat” principle, the analysis strategy evaluated all participants according to their assigned groups. Results for both primary and secondary outcomes exhibit- ed significant differences between the treatment and control groups (p<0.05). The Mother’s Role Achievement Module demon- strated a substantial impact on variables including Breastfeeding Frequency, Weight Gain, Breastfeeding Technique, Breast Care, and Nutritional Intake. The experimental group excelled in these aspects, underscoring the intervention’s effectiveness. This report encompasses all findings, encompassing null and negative results, while pre-specified causal pathways for the intervention were not assessed. Beyond primary and secondary outcome analyses, no additional analyses were conducted. Throughout the intervention, no adverse events or unintended effects were reported in either study condition. The impact of implementing the Mother’s Role Achievement Module on breastfeeding success was assessed using the Mann- Whitney test and Chi-Square analysis due to the nature of the data being on ordinal and nominal scales. The criterion for significance was set at a p<0.05. Table 3 illustrates that statistical tests (Mann-Whitney and Chi- Square) performed on variables like Breastfeeding Frequency, Weight Gain, Breastfeeding Technique, Breast Care, and Nutritional Intake resulted in p<0.05. This indicates a significant difference in these variables between the groups. In simpler terms, Transforming Healthcare in Low-Resource Settings: a Multidisciplinary Approach Towards Sustainable Solutions Table 1. Analysis of respondent characteristics: examining participant characteristics in the health belief model-based mother's role achievement model study (n=60). Characteristic Category Experimental Control p n % Mean±SD n % Mean±SD Gestational age 34 Weeks 1 3.3 0 0.0 0.313b 36 Weeks 2 6.7 1 3.3 37 Weeks 11 36.7 10 33.3 38 Weeks 3 10.0 10 33.3 39 Weeks 8 26.7 6 20.0 40 Weeks 5 16.7 3 10.0 Education Elementary 4 13.3 1 3.3 0.231b Junior High 3 10.0 7 23.3 Senior High 21 70.0 18 60.0 Higher education 2 6.7 4 13.3 Age 23.20 ± 2.83 23.37 ± 2.63 0.715a aMann Whitney test; bChi-Square test; SD, standard deviation. [Healthcare in Low-resource Settings 2024;12:11941] [page 145] Non -co mmerc ial us e o nly implementing the Mother’s Role Achievement Module significant- ly influences Breastfeeding Frequency, Weight Gain, Breastfeeding Technique, Breast Care, and Nutritional Intake. Additionally, the descriptive analysis indicates that the experimen- tal group showed superior performance compared to the control group, highlighting the effectiveness of the Mother’s Role Achievement Module in improving Breastfeeding Success. Discussion The study investigated how the Mother’s Role Achievement Module affected breastfeeding practices in postpartum mothers. The intervention notably increased maternal breastfeeding motiva- tion compared to limited support in the control group, with the experimental group excelling in various aspects despite not prac- ticing EIBF, while the control group faced challenges without extensive support. Interaction with healthcare providers signifi- cantly boosted breastfeeding motivation in the intervention group, reflected in higher post-test scores compared to the control group’s leaflet intervention. Another study in the Bergas District found that while most mothers had high motivation for exclusive breastfeed- ing, workload level didn’t significantly impact this motivation when robust support systems were in place.17 In a study with a 95% participation rate and an 88.4% breast- feeding initiation rate, a positive trend in breastfeeding intentions was observed. The intention to exclusively breastfeed increased linearly from 71.9% in 2005 to 76.8% in 2008. Factors associated with higher motivation for exclusive breastfeeding included older age, primiparity, and spontaneous deliveries. Conversely, lower motivation was linked to factors such as infrequent attendance at prenatal classes, lower educational levels, reduced incomes, German nationality, and tobacco use.18 Another study, employing Kendall’s Tau correlation analysis, highlighted a strong positive link between mothers’ knowledge about Exclusive Breastfeeding and their motivation for it. Mothers’ knowledge contributed signif- icantly, explaining 83.8% of the motivation. Both aspects were moderately rated, suggesting potential for improvement in both knowledge and motivation for Exclusive Breastfeeding.19 Various factors influenced breastfeeding self-efficacy, including informa- tion resources, job status, and education level. However, it was not a predictor or antecedent of effective breastfeeding behavior.20 In the prior study, surveyed mothers displayed high levels of both marital adjustment and breastfeeding self-efficacy. However, no significant correlation between these two factors was found, implying the potential benefits of involving fathers in co-parenting strategies within breastfeeding interventions to enhance their sup- port and engagement in the process.21 The study revealed significant differences in breastfeeding- related variables between groups, affirming the module’s effective- ness. Postpartum mothers, primarily first-time participants, encountered physical challenges and emotional fluctuations that Transforming Healthcare in Low-Resource Settings: a Multidisciplinary Approach Towards Sustainable Solutions Table 3. Impact of mother's role achievement module: assessing the effects of the mother's role achievement module on breastfeeding success in postpar- tum mothers. Variable Statistics Sig. Descriptionl Frequency of feeding -2.679a 0.007 Significant Weight gain -2.581a 0.010 Significant Breastfeeding techniques -2.612a 0.009 Significant Breast care 6.126b 0.047 Significant Nutritional intake -4.175a 0.000 Significant aMann Whitney test; bChi-Square test. [page 146] [Healthcare in Low-resource Settings 2024;12:11941] Table 2. Breastfeeding success variable description: understanding breastfeeding success in the health belief model-based mother's role achievement model study. Variable Category Experiment Control n % n % EIBF EIBF not implemented 30 100 30 100 EIBF Implemented 0 0 0 0 Frequency of feeding Less 5 16.7 15 50.0 Normal 14 46.7 10 33.3 More 11 36.7 5 16.7 Weight gain Decrease 7 23.3 15 50.0 Remain 11 36.7 11 36.7 Increase 12 40.0 4 13.3 Breastfeeding techniques Less 9 30.0 17 56.7 Adequate 11 36.7 11 36.7 Properly 10 33.3 2 6.7 Breast care Less 5 16.7 12 40.0 Adequate 11 36.7 12 40.0 Properly 14 46.7 6 20.0 Nutritional intake Deficit 2 6.7 20 66.7 Normal 22 73.3 7 23.3 More 6 20.0 3 10.0 n, number of participants; EIBF, early initial of breastfeeding. Non -co mmerc ial us e o nly could affect breastfeeding support. Gianni et al. (2020) further explore these challenges in first-time postpartum mothers, support- ing the view that emotional and physical aspects significantly influence breastfeeding practices.22 Differences in cultural beliefs and attitudes between groups hint at varied effects of support. Beggs et al. (2021) delved into cultural differences’ impact on breastfeeding support, reinforcing the observation of diverse effects in your study. This highlights the crucial role of cultural contexts in shaping effective breastfeeding interventions.23 However, both groups showed notable enhancements in maternal breastfeeding ability scores post-intervention, indicating the over- all effectiveness of the intervention. A previous study’s results demonstrate a statistically significant influence of the lactation management module on breastfeeding self-efficacy and the suc- cess of breastfeeding. This underscores the module’s effectiveness in positively impacting these crucial aspects of breastfeeding. Overall, the study confirms the significant role played by the lac- tation management module in enhancing breastfeeding self-effica- cy and overall breastfeeding success.24 Another study demonstrated that breastfeeding training signif- icantly increased self-efficacy and success rates. The findings emphasized the effectiveness of breastfeeding training in enhanc- ing mothers’ self-efficacy and prolonging exclusive breastfeeding, while indicating no significant impact from paternal support.25 Recommendations from these studies highlight the integration of educational methods encompassing structured programs, module- based learning, and hands-on training for healthcare professionals. It also suggests using assistive devices to address breastfeeding challenges. Aligning organizational strategies with these approach- es could significantly improve breastfeeding success in pediatric healthcare settings.26 This suggests that customized lactation edu- cation modules could notably enhance breastfeeding mothers’ self- efficacy.27 Additionally, healthcare providers documented breast- feeding education in medical records 52% of the time, highlighting a positive impact on clinical practice.28 The analysis of the study’s key findings demonstrated that the odds of breastfeeding were pos- itively impacted by receiving curricular modules and participating in a postpartum visit. Additionally, the odds of exclusive breast- feeding were significantly higher for those who had a postpartum visit. This collaborative effort between the community and academia uncovered specific intervention components that sub- stantially improved the likelihood of breastfeeding success in a high-risk population.29 The intervention group, primarily comprising participants with less favorable cultural beliefs and attitudes toward breastfeeding, significantly benefited from breastfeeding demonstrations and sup- port provided by healthcare providers. Research by Jacobzon et al. (2022) emphasized the critical role of healthcare providers in edu- cating postpartum mothers about breastfeeding techniques and care. The study underscored the limited knowledge often observed among first-time mothers and the importance of interventions led by healthcare providers to address these gaps.30 These providers imparted crucial information to the control and intervention groups, recognizing the limited knowledge typically held by post- partum primiparous mothers regarding proper breastfeeding tech- niques and care, as emphasized. Healthcare providers are pivotal in delivering comprehensive health education to mothers, employing various methods, including leaflets, posters, counseling, demon- strations, and breastfeeding support. Healthcare providers should note that a significant portion of the study participants faced diffi- culties attaining exclusive breastfeeding success. To address the issue of unsuccessful exclusive breastfeeding, healthcare providers must proactively assess maternal factors, including preferences for formula milk, mode of delivery, and the adequacy of breast milk.31 This educational approach aims to enhance mothers’ knowl- edge, proficiency in breastfeeding, and positive attitudes and behaviors. Importantly, this health education can be administered both before and after childbirth and may include practical demon- strations and guidance from healthcare providers, collectively con- stituting advanced health education for breastfeeding mothers. Balancing maternal income, dietary diversity, and respecting cul- tural values in the context of breastfeeding is critical. It’s essential to avoid situations where breastfeeding and childcare become overwhelming and isolating for mothers. Additionally, involving fathers in breastfeeding decisions and safeguarding cultural beliefs related to Infant and Young Child Feeding (IYCF) practices.32 In the analysis of the findings, four central themes emerged: ‘recom- mended dietary choices and behavior,’ ‘restricted dietary choices and behavior,’ ‘consequences of adhering to cultural taboos,’ and ‘the evolving landscape of cultural beliefs.’ These findings provide valuable insights for healthcare providers. They can leverage this information to create educational programs that are culturally sen- sitive and tailored to meet the needs of contemporary parents.33 Cultural beliefs have profoundly influenced traditional infant care practices, shaping maternal dietary choices and breastfeeding behaviors. Mothers, guided by these entrenched beliefs, adhered to dietary restrictions, avoiding foods like green leafy vegetables, liq- uids, and hot meals, believing that these choices would safeguard their infants’ health. The study participants attributed physical dis- comforts, such as weight loss, nipple inflammation, and backach- es, to the demands of intense breastfeeding and prolonged sitting. Research by Scime et al. (2023) delved into the experiences of postpartum mothers and their perceptions of physical discomforts associated with breastfeeding. The study identified common com- plaints such as weight loss, nipple inflammation, and backaches, echoing the physical challenges reported by your study partici- pants.34 Furthermore, cultural customs, including providing water to infants for survival and administering charm water for religious and protective purposes, exemplify the far-reaching impact of these cultural beliefs on infant feeding practices. Additionally, these cultural beliefs were manifestations of the perception that breast milk adequacy correlated with breast size and introducing pre-lacteal feeds in early infancy to enhance men’s physical strength. These factors collectively contribute to the low preva- lence of exclusive breastfeeding among mothers, underscoring the enduring power of cultural traditions in shaping maternal and infant care practices.35 The study’s implications suggest adopting culturally sensitive interventions like the Mother’s Role Achievement Module in Indonesian postpartum care settings and similar cultural contexts. Future research should adapt and assess intervention effectiveness across diverse cultures, aiming to sustain breastfeeding success beyond the immediate postpartum period. This study enriches our comprehension of interventions in enhancing breastfeeding and emphasizes integrating cultural perspectives into healthcare pro- grams. Healthcare professionals, by incorporating culturally sensi- tive approaches, can significantly promote breastfeeding success among postpartum mothers. Acknowledging the study’s limitations – like the relatively small sample size impacting generalizability – we urge further research to delve into other aspects of breastfeeding practices and maternal-infant health. By acting upon the evidence presented, healthcare providers, policymakers, and researchers can imple- ment evidence-based strategies to bolster breastfeeding success and maternal-infant well-being in our communities. Transforming Healthcare in Low-Resource Settings: a Multidisciplinary Approach Towards Sustainable Solutions [Healthcare in Low-resource Settings 2024;12:11941] [page 147] Non -co mmerc ial us e o nly Conclusions In conclusion, this study highlights the significant impact of the Mother’s Role Achievement Module, based on the Health Belief Model, in enhancing maternal role attainment and breastfeeding success among postpartum mothers. This underscores the impor- tance of evidence-based interventions for improved maternal and infant health outcomes. 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Scime NV, Metcalfe A, Nettel-Aguirre A, et al. Breastfeeding difficulties in the first 6 weeks postpartum among mothers with chronic conditions: a latent class analysis. BMC Pregnancy Childbirth 2023;23:90. 35. Sosseh SAL, Barrow A, Lu ZJ. Cultural beliefs, attitudes and perceptions of lactating mothers on exclusive breastfeeding in The Gambia: an ethnographic study. BMC Womens Health 2023;23(1). Transforming Healthcare in Low-Resource Settings: a Multidisciplinary Approach Towards Sustainable Solutions [Healthcare in Low-resource Settings 2024;12:11941] [page 149] Non -co mmerc ial us e o nly