**Abstract**

In Chile the social inequality is the result of the accumulation and concentration of income, wealth and property coming from the prevailing neoliberal model in the chilean economy. Under this model, persistent gaps in basic living standards, precarious assets, disparities in health, and inequalities in well-being, employment, treatment and safety of people have been configured. Using the case study methodology, evidence of the phenomenon is presented, making an analysis of the expression of poverty and other social determinants in the results of the reproductive health of socially vulnerable women. Scientific literature on the situation of exclusion and invisibility of subgroups of women who have experienced domestic violence, unplanned pregnancy, early motherhood, migration and ethnic status is analyzed. In turn, the results of effective transfers of health and social benefits to women in social adversity are mentioned in the management of health policy and the social protection system. Finally, a reflection is presented on the need for innovation in the processes of human capital formation in health and social science, and as a response, strategies are proposed to address it to from the complexity of the phenomenon of vulnerability and inequality in reproductive health analyzed.

**Keywords:** poverty, reproductive health, public health, vulnerability, reproductive rights

#### **1. Introduction**

Equity is not synonymous with equality, because equality means to give value to the inequalities, from the idea of justice, therefore, this premise demands a social epidemiological approach to value inequities and inequalities as health problems determinants [1]. Health equity implies, ideally, that everyone should have the opportunity to attain their full health potential and no one should be excluded to reach such potential [1]. This equity is then defined as equality of access to the health care comparing the same needs; equality in the use of resources for the same needs; equality of quality of care and equality of health results [2, 3]. Disparities and inequalities in health are an objective expression of the socioeconomic disadvantage accumulated by the individuals throughout their lifetime, which should be prevented with timely intervention strategies, where the intensity and duration of which would vary according to the degree of vulnerability [4]. The scientific literature has given a fund of evidence about the influence that the social determinants have on the individual and familiar health, as the substratum of diverse illnesses that manifest regardless the universal access that people may have to health systems [5, 6]. The social inequality is the result of the accumulation and concentration of

incomes, wealth and property coming from the prevailing neoliberal model in the Chilean economy [7–10]. Under this model have raised public, economic, political and social policies [9], which have set a new generation of inequalities expressed in persistent gaps in the basic living standards, the precariousness of assets, negatively affected emotional ties and solidarity, health disparities and inequalities regarding well-being, jobs, treatment and security of people in their communities [8, 11–15].

Currently, Chile is recognized as the Latin American country with the highest human development index (HDI), according data of 2020 (0.851), the lowest poverty rate and one of the highest levels of per capita income in the region [11, 15]. The country is in the world's 62nd place in the Gender Development Index (GDI) and 39nd place in Gender Index scores about 2019 across 129 countries, at the same time, has one of the highest inequality rates in Latin America, being the country with the most inequality of the Organization for Economic Cooperation and Development [16, 17]. When we consider the inequality as a result of the inequality of incomes, education and health, the country fall 11 places in the world's ranking, falling to the 54th place (Chile's HDI falls from 0.851 to 0.709) [15]. Considering this context, the chilean society shows and keeps deep inequalities, inequities and differences that generate a sense of growing frustration, mistrust and social unrest in the population [14, 18–19].

## **2. Methodology**

To address the situation of poverty, inequality, reproductive health, a case study is carried out to understand the how and why of the causes and consequences of the phenomena that occurred in Chile, unit of analysis, regarding the subject under study. The case study corresponds to an empirical investigation based on a set of heterogeneous evidences in its origin and that converge in the explanation of a set of contemporary phenomena that arise in real life regarding poverty, inequality, reproductive health and public policies. Objective methods of searching for evidence are used through repositories of university databases and Chilean and international public organizations. The foregoing is complemented with information from studies carried out by the author with a team of researchers who approached the research on the subject in question in particular groups and territories and that account for the knowledge generated in the field work.

Finally, three strategies are presented for the development of competencies and skills in transdisciplinary and integrated management practices in primary health care for midwifery students and academics and student from other health and social science careers-professions.
