Latin American is characterised by high levels of income and opportunities inequality. Access to health care services, including to preventive health care, is limited for the poor and vulnerable; and in the case of women, this situation is worse. Two main factors are recognised as the main sources limiting access to health care services for poor women in Latin America: discrimination and the established social roles of women in society.

The book Gender, Globalization and Health in a Latin American Context presents an in-depth description and analysis of how aspects related to gender inequality affect access to health care services in the region, and uses Chile as the main example. The author bases her analysis in a macro‒meso‒micro framework to illustrate how institutions (meso) influence national policies (macro) and health outcomes (micro). Additionally, she emphasises in how institutions have ignored the role of women in a society, and usually assume women to be married and dependent on men.

The book starts exploring the social policy context in Latin America. It first presents how the role of woman in a household has been overemphasised by the current global development policies oriented to poverty reduction and to some extent by the health care reforms implemented in the last three decades. Those policies have ignored feminist voices and assumed a passive role for women in the labour market. This chapter presents the need to establish social policies in health care, aiming to promote gender justice, using a perspective of gender equality (absence of discrimination) instead of gender equity (equity in provision of health services).

The discussion makes a strong argument about how the development of social security systems has been based on different perceptions and assumptions about gender roles. This argument becomes more evident when the analysis moves to the effect of neoliberal reforms on the provision of formal and informal health care, and to how the costs assumed by a household have increased after the reforms. Indeed, these reforms ignored women's participation in the labour market, and how this aspect plays a fundamental role on who provides informal care inside a household.

The selection of Chile as the main illustrative example was justified given the severity of the neoliberal reforms implemented during the 1970s and 1980s. The description and analysis of the health care system in this country allows the reader to understand how market policies in health care discriminate against women, overemphasise their role as caregivers and ignore their participation in the formal and informal labour market. Throughout the book, these aspects become more evident when the discussion moves to describe how access to private health care insurances has been limited by higher costs of health care packages or reduced benefits (lower number of services covered by the same price).

Unpaid care plays an important and almost fundamental role in the discussion of women and health care. The lack of recognition of this topic in the public agenda ‒ in Chile and in most Latin American countries ‒ exemplifies how systems are based on assumptions about gender roles and how health care systems have ignored women's participation in the labour market and changes in individuals’ family roles. At this point, the author recognises how meso-institutions in Latin America have established policies based on a male breadwinner model, where women have access to health care as dependents and do not participate actively in the labour market. It is assumed that women have a role as mothers and wives and as a result they can take care of sick household members.

Although the book emphasises in the role of meso-level institutions, it also presents how macro institutions have affected the way health care services are structured and how the needs of different groups (including women) are recognised. In the case of Chile, this point is illustrated, when reproductive health laws in this country are analysed. Indeed, the discussion around this topic has depended on the government in charge, and it has been restricted by the lack of visibility and voice women have in the public agenda.

The whole analysis recognises how the structure of the Latin American health care system has ignored the needs of women and most important vulnerable (or poor) women. The book leaves the clear message that there is a need to develop a gendered health care agenda, where women are seen as active subjects and members of a society. In addition, the analysis of Chile presents an illustration of how discussions around reproductive health or women's rights on health has been truncated and limited by the lack of commitment to work on these topics that policy makers have and the low levels of participation of women in public settings.

The book is enjoyable to read, even though the amount of original empirical evidence introduced is limited. It reviews a large number of sources and relates topics and arguments from different perspectives. It is relevant for scholars working on gender studies and on health care analysis. It provides an in-depth analysis of how social, political, economic and cultural structures in Latin America and in Chile have affected how health care systems are structured, and, most important, how the role of women is understood inside the system. The book also presents a good and detailed analysis of the structure of the health care system in Chile and how reproductive health care policies have been implemented in this country. Although Chapter 6 introduces to the analysis the topic of migration, this topic is not explored in detail, given the lack of empirical evidence. Nevertheless, the chapter analyses from a gender perspective the existence of a relationship between access to health care, work and migration status in Chile, and how different sources of discrimination make a bad situation even worse.

The author fulfils the objective of analysing how aspects related to cultural gender roles have had a negative effect on the structure of the Chilean's health care systems. Moreover, it emphasises how unpaid care is usually ignored in the public agenda and how the role that women play in a household has been underestimated. Finally, the analysis presented in Chapters 3, 4 and 5 will allow the reader to understand how health care systems in Latin America and Chile have failed to introduce a gender equality perspective and demonstrate a lack of knowledge of the real role that women have in society.