Least developed countries and small island states have been receiving support from developed countries to prepare National Adaptation Programmes of Action (NAPAs) to address the impacts of climate change. The NAPAs reflect what is currently intended to take place on the ground to respond concretely to the challenges of climate change. A review of health considerations within these plans has been undertaken. The review focused on three main aspects: identified health impacts; adaptation needs and proposed adaptation actions; and, the implementation framework. It was found that 39 of 41 NAPAs reviewed (95 percent) consider health as being one of the sectors on which climate change is seen as having an impact. However, only 23 percent (9/39) of these plans were found to be comprehensive in their health-vulnerability assessment. In total, 73 percent (30/41) of the NAPAs include health interventions within adaptation needs and proposed actions, but only 27 percent (8/30) of these interventions are found to be adequate. The total number of selected priority projects is 459 but only 50 (11 percent) represent projects focused on health. The total estimated cost of the priority projects is USD 1,852,726,528 with just USD 57,777,770 (3 percent) going to health projects. It is concluded that with few exceptions, the current consideration of public health interventions in NAPAs is unlikely to support the resilience processes and protect public health from the negative effects of climate change.