Reviewing 41 National Adaptation Programmes of Action (NAPA), this paper identifies the range of interventions implemented by least developed countries (LDCs) and the structural issues that hamper better alignment of climate change adaptation and national development planning. The paper analyses the varying degrees of integration of NAPAs into development plans and identifies a lack of cross-ministerial bodies as a barrier to alignment. It then takes the issue of population as an example for the need for longer-term approaches to adaptation. 37 NAPAs explicitly identify population growth as relevant for climate change adaptation strategies through five factors:

Food Security – increases vulnerability during food shortages and drought and strains capacity for supply (particularly where people rely on unsustainable food resources i.e. fishing stocks).
Natural resource depletion/degradation – a central theme of NAPAs, the list includes (among others) deforestation pressures in Mozambique, Rwanda and Sierra Leone; excessive fishing in Kiribati; ecological imbalances in Niger; and a degrading highland ecosystem in Uganda.
Water resource scarcity – deemed to increase demand for water, Sudan and Zambia are highlighted as already experiencing significant water-related pressures.
Poor human health – Uganda, Tuvalu and Kiribati have all experienced increased pressures arising from the spread of waterborne diseases, a risk associated with high-density population areas.
Migration and urbanisation – changing climate and rising sea-levels will add to growing numbers of people migrating to urban areas often already lacking in basic infrastructure. The paper also discusses examples of family planning and reproductive health adaptation strategies.

The paper concludes with three main recommendations for strategies that better meet the development needs of target countries:

Alternate structures must be created to link meteorological and environmental ministries with those responsible for national development, so that climate change can be incorporated into development plans. This should be done at a high-level, possibly a commission located in the president/prime minister's office.
A mix of short- and longer-term participatory projects across sectors is important, including those sectors not associated with adaptation under the UNFCCC (such as education).
A focus on population, including family planning, women’s education and empowerment, should be included in long–term adaptation strategies and national development plans.