| Summary: | Reverse osmosis (RO) drinking water stations have been introduced to provide safe drinking water for areas with prevailing chronic kidney disease with unknown (CKDu) etiology in the dry zone of Sri Lanka. In this investigation, RO drinking water stations established by community-based organizations (CBO) in the North Central Province (NCP) were examined. Water samples were collected from source, permeate, and concentrate in each station to determine water quality and performance. Furthermore, the operators of the systems were interviewed to evaluate operational and maintenance practices to identify major issues related to the RO systems. Results show that the majority (>93%) of RO systems had higher salt rejection rates (>92%), while water recovery varied from 19.4% to 64%. The removal efficiencies of hardness and alkalinity were averaged at 95.8% and 86.6%, respectively. Most dominant ions such as Ca<sup>2+</sup>, Mg<sup>2+</sup>, K<sup>+</sup>, Na<sup>+</sup>, Ba<sup>2+</sup>, Sr<sup>2+</sup> Cl<sup>−</sup>, F<sup>−</sup>, and SO<sub>4</sub><sup>2−</sup> showed higher rejections at averaged values of 93.5%, 97.4%, 86.6%, 90.8%, 95.4%, 96.3%, 95.7%, 96.6%, and 99.0%, respectively. Low recovery rates, lower fluoride levels in product water, and membrane fouling were the main challenges. Lack of knowledge and training were the major issues that could shorten the lifespan of RO systems.
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