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Background  Most water access studies involve self-reported measures such as time spent or simple spatial measures such as Euclidean distance from home to source. GPS-based measures of access are often considered  actual  access and have shown little correlation with self-reported measures. One main obstacle to widespread use of GPS-based measurement of access to water has been technological limitations (e.g., battery life). As such, GPS-based measures have been limited by time and in sample size.    Methods  The aim of this pilot study was to develop and test a novel GPS unit, (≤4-week battery life, waterproof) to measure access to water. The GPS-based method was pilot-tested to estimate number of trips per day, time spent and distance traveled to source for all water collected over a 3-day period in five households in south-western Uganda. This method was then compared to self-reported measures and commonly used spatial measures of access for the same households.    Results  Time spent collecting water was significantly overestimated using a self-reported measure, compared to GPS-based (p < 0.05). In contrast, both the GIS Euclidean distances to nearest and actual primary source significantly underestimated distances traveled, compared to the GPS-based measurement of actual travel paths to water source (p < 0.05). Households did not consistently collect water from the source nearest their home. Comparisons between the GPS-based measure and self-reported meters traveled were not made, as respondents did not feel that they could accurately estimate distance. However, there was complete agreement between self-reported primary source and GPS-based.    Conclusions  Reliance on cross-sectional self-reported or simple GIS measures leads to misclassification in water access measurement. This new method offers reductions in such errors and may aid in understanding dynamic measures of access to water for health studies.

Comparison of methods to estimate water access: a pilot study of a GPS-based approach in low resource settings