OBJECTIVES: This analysis aims to evaluate the situation of sexual and reproductive health in the Department of Bolívar, focusing on fertility and maternal mortality, and their socioeconomic and public health determinants.

METHODS: A participatory methodology based on the guide from the Ministry of Health and Social Protection was used, collecting data from various sources such as DANE, SISPRO, and SIVIGILA. Indicators of fertility, maternal mortality, and morbidity related to sexual and reproductive health were analyzed, contextualized within the socioeconomic and demographic environment of Bolívar.

RESULTS: Between January and December 2023, 5.9% of births registered in Colombia occurred in Bolívar, with 51.2% of these in Cartagena. The specific fertility rate for adolescents in Cartagena was 50.1 births per thousand women aged 15 to 19, exceeding the national average (39.4 per thousand) but below the departmental rate (59.7 per thousand). In 2022, Bolívar recorded a maternal mortality ratio of 64.9 deaths per 100,000 live births, with 7.9% of the national maternal deaths within 42 days occurring in Bolívar. In Cartagena, the ratio was 58.4 deaths per 100,000 live births.

CONCLUSIONS: The analysis reveals high rates of adolescent fertility and maternal mortality in Bolívar, indicating an urgent need for specific public health interventions. Disparities between Cartagena and the rest of the department highlight the importance of regional approaches in health policies. Strategies should focus on improving sexual and reproductive health services, comprehensive sexual education, and reducing socioeconomic inequalities to achieve a significant impact on the population's health.