In 2016, about 200 units of the Earth Auger sanitation technology were implemented at Ida farmsteads in the Eastern Cape Province in South Africa. This study undertook an assessment of user acceptance and institutional satisfaction and concerns about the technology post-implementation. Employing a combination of quantitative and qualitative research methods within a case study area of Ida community, survey questionnaires were used to collect data from 45% of the beneficiary households (n=90) and 4 local institutions involved in the technology deployment and affected by its performance. Findings revealed a high non-usage (97%) and low usage (3%) of the technology. Key factors underpinning the low usage related to pre-planning deficiencies, inherent design constraints and operational difficulties. The study also revealed that institutional concerns outweighed institutional satisfaction with the technology. Thus, the study concludes tha