Climate change has compounding effects on development, including direct and indirect impacts on food systems and human health. In the Pacific Islands region, the incidence of non-communicable diseases is among the highest in the world. Additionally, in policy documents, climate change features prominently among the issues most responsible for hindering development in the Pacific. Global discussions are now shifting towards a greater understanding and emphasis on the links between climate change, food systems, nutrition, health, and development. While these links are increasingly appreciated in research and practice, there is a need to understand which types of policy frameworks are best suited to address these issues in an integrated manner. This study was conducted by analyzing policy alignment and coherence in national level strategic planning instruments (policies, plans, and strategies) for two countries in the Pacific Islands region: Fiji and Vanuatu. Documents in the policy domains of development, agriculture, nutrition, health, and climate change were assessed to identify evidence of vertical (national to local), horizontal (between sectors), and integration across different thematic policy approaches (e.g. between economic development sustainable development approaches). By deconstructing the aims of different planning approaches and documents, and by mapping the relationships among them, it is possible to identify opportunities and gaps in the policy architecture that could be addressed in future planning cycles. The study identifies that policy alignment and coherence need to be explicitly addressed in the policy and planning design stage and included in monitoring and evaluation frameworks. The study also highlights the lag in the design and implementation of comprehensive food and nutrition security strategies in both countries and these lags can be linked to policy solutions for agriculture, health, and climate change. Key policy insights There is a need to explicitly consider policy alignment in the design stages of the policy cycle and set policy coherence as an explicit outcome to also be included in monitoring and evaluation frameworks. A lack of consideration of vertical, horizontal, and approach integration in planning and policy processes can lead to failures in the implementation of climate policy, thus delaying countries' efforts towards achieving the Sustainable Development Goals (SDGs). Pacific Island countries have an opportunity to work towards use of policy frameworks that are able to provide comprehensive responses to the compounding effects of climate change on food systems, diets, health, and, more broadly, on development.