Globally, approximately two billion people drink contaminated water. Use of household water treatment (HWT) methods, such as locally manufactured ceramic filters, reduces the diarrheal disease burden associated with unclean water. We evaluated the quality, effectiveness, and acceptability of ceramic filters in two communities in Arusha, Tanzania, by conducting: 1) baseline household surveys with 50 families; 2) filter flow rate testing; 3) filter distribution with training sessions; 4) follow-up surveys at 2, 4, and 6 weeks after distribution; and 5) project end focus group discussions. We tested Escherichia coli (E. coli) and turbidity at baseline and the first two follow-ups. We found: 1) filter quality was low, as only 46% of filters met recommended flow rate guidelines and 18% of filters broke during the 6-week study; 2) filter effectiveness was moderate, with 8% and 35% of filters effectively reducing E. coli to <1 CFU/100 mL and <10 CFU/100 mL, respectively, at follow-ups; and, 3) filter acceptability was high, with 94% overall satisfaction and 96–100% reported use in the previous day. These results highlight the importance of mixed methods research as HWT product quality, effectiveness, and acceptability all impact product efficacy, and the need for quality assurance/quality control and certification schemes for locally manufactured HWT products.

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