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Privatisation in the health sector in Chile was first initiated under the military dictatorship of General Pinochet, a government which espoused very conservative views of women and reproductive rights. At the same time, research has pointed to the gendered historical legacies that have clearly shaped patterns of access and usage within the health system. Debates around the role of the private sector in health have highlighted the importance of accountability structures if health inequalities are to be effectively addressed by private providers. Drawing on the case of Chile, this paper therefore considers the gendered nature of accountability structures in the private sector in health and what this can potentially contribute to promoting gender equality and gender justice in health.