A major new Health Research Council (HRC) grant will support Waipapa Taumata Rau, University of Auckland, to lead a transformative Pacific-led study focused on improving care for Pasifika women with diabetes in pregnancy (DiP).
The research aims to strengthen culturally grounded care and achieve better health outcomes for Pasifika mothers and their pēpē. Researcher Moananu Dr Karaponi Okesene-Gafa will lead the 36‑month, $1,199,916 project, “Co-designing with Pasifika families to improve diabetes in pregnancy management.”
The study will centre Pacific voices, values and lived realities in reshaping care.
Pasifika women in Aotearoa experience disproportionately high rates of diabetes in pregnancy, contributing to serious health challenges for both mothers and babies, including higher rates of perinatal mortality.
Hyperglycaemia (high blood sugar in pregnancy) is associated with complications such as macrosomia (larger-than-average babies), preterm birth (before 37 weeks) and neonatal hypoglycaemia (low sugar in the baby) — are linked to adverse health outcomes and may contribute to significant long-term social and economic impacts.
Despite strong evidence that lifestyle interventions and, where necessary, pharmacotherapy can effectively manage DiP, current care models do not deliver equitable outcomes for Pacific communities.
“Too often, Pacific women are navigating systems that weren’t designed with them in mind,” says Dr Okesene-Gafa. “We know what works clinically, but the way care is delivered can miss the cultural, family and social realities that shape whether that care is accessible, understood, achievable and sustained.”
Co-designing solutions with Pacific communities
At the heart of the project is a co-design approach that brings together Pasifika women, their families and whānau, and health professionals to create a culturally grounded model of care.
Rather than applying pre-existing frameworks, the research will embed Pacific worldviews—recognising the central role of family, collective wellbeing, spirituality, and community support systems.
“Pacific women have consistently told us that managing diabetes in pregnancy is challenging—not because they lack commitment, but because the system doesn’t always support them in ways that reflect their realities,” Dr Okesene-Gafa says.
“This research is about listening deeply and building solutions together— honouring Pacific knowledge and values, strengthening families, and working alongside clinicians to deliver care that is easy to understand, accessible and work in everyday life.”
Using a co-design approach, the research will tackle barriers such as limited culturally appropriate health information and fragmented services, aiming to improve care for diabetes in pregnancy and reduce avoidable hospital admissions.
Aligning with national health priorities
The study responds directly to national health priorities to improve equity and outcomes for Pacific peoples, while strengthening workforce capability and system responsiveness.
Professor Sir Collin Tukuitonga, co-director of Te Poutoko Ora a Kiwa – Centre for Pacific and Global Health, says the project represents exactly the kind of leadership needed to reduce longstanding inequities.
“This is a significant and timely investment in Pacific health research,” says Professor Tukuitonga. “Diabetes in pregnancy is a critical issue for our communities, and the consequences can be intergenerational.”
“What makes this work powerful is its foundation in Pacific ways of knowing and doing. Co-design with families ensures that the solutions are not only clinically sound, but culturally meaningful and practical.”
Toward better outcomes for mothers and babies
By reimagining care delivery through a Pacific lens, the research aims to improve management of diabetes in pregnancy, enhance service delivery, and ultimately reduce adverse health outcomes.
“When care works for Pacific families, it works better for everyone,” Okesene-Gafa says. “Improving outcomes for mothers and babies also reduces long-term health and economic costs for the wider system.”
The project is expected to deliver a scalable and adaptable model that could inform future health services across Aotearoa, ensuring that Pacific women receive care that is not only effective—but also respectful, empowering and grounded in community.
Waipapa Taumata Rau, University of Auckland media release.
