One of the most rational adaptation strategies to global change in Pacific Island Countries appears to be overcoming current challenges by building on the recognised strengths and resilience of island communities, strengthening institutional structures and human resources, while maintaining or enhancing the ecosystems on which island communities depend. Aid agencies and donors have seen the development of national water policy as a key step in adaptation. This work describes experiences in assisting Kiribati, Nauru, Solomon Islands and Tokelau, Pacific countries with varying dependencies on groundwater, to develop national water policies and associated implementation plans. Existing developed world policy frame works, templates and tool kits were of little use in countries were the policy development process is rudimentary or, as in one case, non-existent, and where only one or two people are responsible for water management. Ackoff’s five phases of interactive planning was a useful, easily- understood process for identifying issues and arriving at policy and implementation plans. Because this is an adaptive, iterative process, it is fundamentally important that it is carried out with a whole-of-government and community-representative steering group, particularly with women’s group representatives. A sticking point in the development of attendant national water legislation is the traditional view that land ownership implies ownership of surface and groundwater. While success in policy development is seen as Cabinet approval of policy or plans, successful ownership and implementation of policy is more problematic, particularly in protection of water sources. Long-term mentoring of water agencies has many positive benefits.