Sri Lanka was devastated by the 2004 Indian Ocean tsunami. During recovery, the Red Cross distributed approximately 12,000 free ceramic water filters. This cross-sectional study was an independent post-implementation assessment of 452 households that received filters, to determine the proportion still using filters, household characteristics associated with use, and quality of household drinking water. The proportion of continued users was high (76%). The most common household water sources were taps or shallow wells. The majority (82%) of users used filtered water for drinking only. Mean filter flow rate was 1.12 L/hr (0.80 L/hr for households with taps and 0.71 for those with wells). Water quality varied by source; households using tap water had source water of high microbial quality. Filters improved water quality, reducing Escherichia coli for households (largely well users) with high levels in their source water. Households were satisfied with filters and are potentially long-term users. To promote sustained use, recovery filter distribution efforts should try to identify households at greatest long-term risk, particularly those who have not moved to safer water sources during recovery. They should be joined with long-term commitment to building supply chains and local production capacity to ensure safe water access.

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