OBJECTIVES: To generate and evaluate an indicator of the performance of health systems for maternal and reproductive health in Colombia. METHODS: An indicator was constructed with variables related to coverage and utilization of health services by pregnant and reproductive-age women. A factor analysis was performed using a polychoric correlation matrix of the factors presented and departments were classified based on the score of the indicator extracted. The relationship between the indicator and the social determinants was evaluated using a path analysis with the maternal mortality ratio as the response variable.  RESULTS: The factor analysis suggests the existence of only one principal factor "coverage and utilization of maternal health services" (eigenvalue 4.35). The best performance of the indicator (Q4) was identified in the departments of Atlantic, Bogota, Boyaca, Cundinamarca, Huila, Risaralda and Santander. The lowest performance (Q1) occurred in Caqueta, Choco, La Guajira, Vichada, Guainia, Amazonas and Vaupes. An association was determined between the indicator’s behavior and the unsatisfied basic needs index and the education of the women (β = -0.021; 95%CI -0031 to -0.01 and β 0.554; 95%CI 0.39 to 0.72, respectively). According to the path described, an inverse relationship was identified between the proposed indicator and the behavior of the maternal mortality ratio (β = -49.34; 95%CI -77.7 to -20.9), for which performance was an intermediary variable. CONCLUSIONS: The indicator presented herein of the performance of the maternal and reproductive health system can be applied to similar contexts in developing countries to identify health inequities. The performance of the health system’s management of outcomes related to access and coverage of maternal and reproductive health appears to function as an intermediary variable between social determinants and maternal mortality in the Colombian departments.