We show that for any n ≥ 4 there exists an equivalence functor [Formula: see text] from the category [Formula: see text] of n-fold connected simple coverings of B3 × [0, 1] branched over ribbon surface tangles up to certain local ribbon moves, and the cobordism category [Formula: see text] of orientable relative 4-dimensional 2-handlebody cobordisms up to 2-deformations. As a consequence, we obtain an equivalence theorem for simple coverings of S3 branched over links, which provides a complete solution to the long-standing Fox–Montesinos covering moves problem. This last result generalizes to coverings of any degree results by the second author and Apostolakis, concerning respectively the case of degree 3 and 4. We also provide an extension of the equivalence theorem to possibly non-simple coverings of S3 branched over embedded graphs. Then, we factor the functor above as [Formula: see text], where [Formula: see text] is an equivalence functor to a universal braided category [Formula: see text] freely generated by a Hopf algebra object H. In this way, we get a complete algebraic description of the category [Formula: see text]. From this we derive an analogous description of the category [Formula: see text] of 2-framed relative 3-dimensional cobordisms, which resolves a problem posed by Kerler.