Antenatal care adequacy before and during the COVID-19 pandemic in indigenous populations in Peru.

Background: During the COVID-19 pandemic in Peru, primary health care services redistributed personnel to hospitals. In this context, Antenatal care (ANC) could have been limited in the general population, especially among indigenous communities. Objective: To determine differences in compliance with adequate ANC based on ethnic groups in Peru prior to and throughout the COVID-19 pandemic. Methods: Observational, retrospective study, secondary analysis of the Demographic and Family Health Survey conducted in the course the period 2017-2022. The sample consisted of women of childbearing age from 15 to 49 years and considered the variables of ethnicity, ANC, and sociodemographic factors. For statistical analysis, generalized linear models from the Poisson family utilizing a logarithmic link function were used. Crude and adjusted Prevalence Ratios were calculated along with their 95% confidence intervals. Results: A total of 20,165 records were reviewed. Before the pandemic, the frequency of inadequate ANC was 57.91%, and during the pandemic, it increased to 64.91%. Compared to mestizos, belonging to the Quechua ethnic group (PR: 1.08; 95% CI: 1.04-1.13), Aymara (PR: 1.21; 95% CI: 1.12-1.30), natives of the Amazon (PR: 1.15; 95% CI: 1.04-1.27), and those belonging to other races (PR: 1.15; 95% CI: 1.02-1.29) had a higher prevalence of inadequate ANC. During the pandemic, only Aymara women maintained a higher prevalence of inadequate ANC (PR: 1.18; 95% CI: 1.06-1.31). Conclusions: Before the pandemic, there were ethnic differences in the prevalence of inadequate ANC, and during the pandemic, only Aymara pregnant women maintained a higher prevalence of inadequate ANC.