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Adaptation to health risk due to climate variability and change at the city level is inadequate, particularly in developing economies. Here, coping strategies with short-term benefits, adopted by the residents contribute significantly to their resilience. Decision on effective adaptation, therefore, requires economic evaluation of the coping and adaptation strategies in practise. In the present paper a novel framework using household health production function (HPF) approach has been developed for evaluation of coping and adaptation strategies to serve as a decision tool for planners. The outcome informs decision makers about the benefits and effectiveness of coping, and shortcomings in the existing adaptation strategies, thus, contributing to stocktaking. The approach has been validated using a case of vector-borne disease of dengue, an important climate-sensitive health impact of climate change. A five step cyclical framework has been proposed which addresses uncertainty by avoiding the need for future projection of health outcomes and scenario building as it can be applied at any point of time in future and considers the current risk only. The strengths and weaknesses of the proposed tool are compared with other similar tools. The decision support tool has applicability for all climate-sensitive health outcomes at the city level.