Small island nations in the Caribbean are highly vulnerable to climate change, whose effects include increased frequency and severity of droughts and increased intensity of tropical storms and hurricanes. Extreme weather and climate events affect directly or indirectly most dimensions of human well being, including mental and physical health, food, housing, freshwater, and livelihoods. Climate-driven early warning systems (EWS) to predict epidemics of dengue fever and other mosquito-borne diseases can help nations to adapt to changing climate conditions. In this study we assessed climate and health sector stakeholder perceptions and needs to inform the development of a dengue EWS. Stakeholders identified capacity limitations (financial resources, trained personnel), and the need for local research on climate-arbovirus linkages to inform decision makers. They identified six key strategies for strengthening the partnership between the climate-health sectors, and they assessed the viability of public health actions that could be take in response to short (2 week), medium (3 month) and long-term (1 year) forecasts of dengue fever epidemics. The results of this study contribute to Caribbean efforts to develop climate services for health, a key adaptation strategy to reduce the health impacts of climate change.