Background: Estimations from the Joint Monitoring program for Water Supply and Sanitation (JMP, 2012) reveal that “less than five percent of water and sanitation interventions are revisited once they have been completed and less than one percent are monitored over the long term”. Since 2000, the Centers for Disease Control and Prevention(CDC) has been working with the American Red Cross (ARC) to evaluate the long-term sustainability of post-disaster water, sanitation and hygiene interventions (WASH) provided in Guatemala, Honduras, Nicaragua and El Salvador. Sustainability assessments were conducted in 2006, 2009 and most recently in 2012. In the 2012 evaluation, a qualitative approached was included to extent the results obtained from quantitative surveys through an exploration of individual perceptions and current practices. Methodology: Key-informant interviews were conducted with the heads of household in 15 communities purposively selected. All interviews were recorded, transcribed, coded and analyzed using the computer assisted qualitative data analysis software MAXQDA10 Results: Interviewees discussed issues related to the quality, safety and adequacy of the water and sanitation infrastructure and hygiene education sessions received. Issues of corruption in the water committees and delayed repair of damaged infrastructure resulting in erratic service were frequently reported. In addition, lack of financial support, community engagement, and equity were identified by heads of household as major limitations to sustain and improve WASH interventions. Conclusions: This exploration provides valuable information to further examine the factors driving people’s adoption of hygienic practices and maintenance of water and sanitation facilities in the Central American region.