A non-randomized assessment of long-term biosand filter (BSF) use and sustainability in the Artibonite Valley near Deschapelles, Haiti was conducted during March, 2011. Of the 55 BSFs visited, 47% were no longer in use. Filter lifespan ranged from <1 year to systems still in use after 12 years. Interviews with BSF owners revealed problems related to intermittent filter use due to travel for employment or personal matters; broken or missing filter parts; and fears that the filter would not be effective against cholera. In addition, 17 BSF field studies were reviewed to identify common issues impacting usage. Culturally appropriate technologies and education materials explaining proper maintenance and operation are essential for improved filter performance and sustainability. For Haiti, education materials should be provided in Creole and French and should include, (1) diagrams and descriptions of how the BSF works, (2) how to troubleshoot common problems, (3) how to properly maintain filters, and (4) a contact in case of questions. Operational problems can be minimized by providing long-term technical support, periodic water quality monitoring, and maintenance assistance for filter users.

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