Equity in Antenatal Care Quality: An Analysis of 11.382 Cases from 23 Municipalities in Colombia

OBJECTIVES: To describe the equity in antenatal care quality (ACQ) in 23 municipalities of the Caribbean Region in Colombia.

METHODS: We analyzed data on the ACQ, as recorded in the delivery care process of 11.382 women. Five criteria were applied to classify ACQ as adequate or inadequate: 1) Number of prenatal checkups, 2) Gestational age at first check-up, 3) Number of ultrasounds performed, 4) Ordering of folic acid, and 5) Trimester in which immediate smoking cessation is ordered. Concentration curves (CC) were constructed, and concentration indices (CI) were estimated for the factors studied.

RESULTS: Inequities related to socio-economic conditions were demonstrated for all factors studied. The estimates suggest that these inequities favor women with better living conditions (except "being the head of the household"). They also show the influence of the level of schooling on the inequities found and the contribution of insurance to their reduction.

CONCLUSIONS: Previous studies that showed inequities in the ACQ in favor of mothers with better socioeconomic conditions were corroborated and possible factors related to the inequitable distribution of resources in different areas of residence of mothers were proposed. The coverage of health insurance and the educational level of the poor and vulnerable population are relevant factors in closing the gaps of the ACQ in this region.