OBJECTIVES: To describe the relationship between poverty and access to prenatal care (APC) in Colombia before (2019) and during the first pandemic year (2020)

METHODS: an ecological study measuring regional inequalities of access indicators to prenatal care in Colombia was carried out for the years 2019 and 2020. Adequate access to prenatal care was defined as having four or more consultations before delivery. Inequalities were measured by estimating incidence rate (IR), rates or proportion difference (DR), and Population-attributable risk (PAR). Poverty was measured using the Unmet Basic Needs (UBN) indicator. Data was obtained from the national agency for population statistics – known as DANE for its initials in Spanish.

RESULTS: In 2010, 2019 and 2020 the APC in Colombia was 22.1%, 16% and 19.6% respectively. Poverty (UBN) explained, to a large extent, the APC in 2019 and in 2020 (R² 2019: 57.5% versus R² 2020: 59.5%). The β coefficient of the lineal regression for 2019 was 0.7087 (CI95%:0.4917-0.9257) and by each percent point that the UBN decreased in the departments, an increment in the APC of 0.7087 percentage points was observed. For 2020, this increment was 0.7063 (CI95%:0.4984-0.9141)

CONCLUSIONS: Colombia's health sector reform has been recognized for its universal health coverage (UHC) scheme. However, for 2019, the effective coverage rate was 74.4% and the regions with the highest poverty have greater access problems to health services like prenatal care.