Lay summary
Pasifika women in Aotearoa experience disproportionately high rates of diabetes in pregnancy (DiP), contributing to poor outcomes including elevated perinatal mortality. Hyperglycaemia is a likely cause of mortality and morbidity such as macrosomia, early birth, and neonatal hypoglycaemia, conditions with significant social and economic costs. While lifestyle (+/- pharmacotherapy) interventions are effective, current approaches are often Eurocentric and overlook Pacific worldviews. Pasifika women consistently report difficulties managing DiP, compounded by limited access to culturally appropriate care, tailored health information and socio-economic barriers. Existing systems often neglect the importance of family, cultural values, and community support. This research will co-design a culturally grounded model of care with Pasifika women, their families/whānau, and health professionals to improve DiP management and service delivery. It aligns with national health policy and strategy by responding to Pacific health needs, strengthening workforce and research capability, and enhancing system responsiveness. Improved care improves outcomes and reduces costs.