Climate change challenges the ability of food systems in Africa to produce sufficient and healthy foods for growing populations. Environmental challenges are predicted to become more profound and adaptation strategies are needed to improve African food system resilience and prevent potential food insecurity and associated adverse health outcomes. Using fully participatory approaches, this project will synthesise evidence and develop novel methods and tools for assessing the health effects of food system adaptations to climate change in Africa. The method will include The Gambia as a case study; a country highly-dependent on small-scale agriculture that is experiencing increasing environmental pressures, including reduced rainfall and rising temperatures. We will synthesise secondary data across environment, food system and health domains to: 1) synthesise evidence on the effectiveness of food system adaptations in the West-African region and quantify the ability of The Gambia’s food system to deliver healthy diets; 2) develop methods to model food systems and health indicators under a business-as-usual scenario; and 3) model and evaluate tested food system adaptation scenarios for The Gambia. The project will define a novel approach to delivering country-specific policy-relevant evidence on the effectiveness of realistic food system adaptations to deliver healthy and sustainable diets for all. In Africa, climate change will profoundly affect the ability of countries to provide sufficient healthy food for their populations. To address this problem, policy makers require country-specific information on effective strategies to adapt to climate change, and ensure sufficient production, import, manufacture and delivery of food for their populations. We will use existing data sources, such as routinely collected environmental, agricultural, nutrition and health data, and evidence on adaptations in agriculture to estimate the ability of national food systems to deliver healthy diets in the future. We will work with policy makers, local researchers and farmers to inform our work and ensure that it realistically addresses country-level concerns. In this project, we will include The Gambia in West Africa as a case study country. We aim to deliver evidence that will be useful for Gambian policy makers and to develop methods that will be transferable to other African countries.