Dear Editor-in-ChiefAccess to public services is not equally distributedin Iran (1). This general rule also includesthe access to health care services as the distributionof facilities is unequal skewed in terms ofgeographic location (2).

Disabled women as well as those without disability have the right to receive reproductive health care services. Since women with mobility impairment face diverse obstacles in receiving reproductive health care, reviewing these services received by them is of grate importance.Determining the reproductive health care services received by women with mobility impairment during disability period, we conducted a descriptive study in which questionnaires were used to collect the data, and the investigation was done on 241 handicapped women, ranged in age from 15-49 and all, members of Iranian handicapped society.The results revealed that 2.9% of the sample group had received sexual counseling before and after marriage, and less than half of them had participated in the family planning care service with all elements (except weight measuring and first visit pelvic exam). All elements of prenatal care (except blood and urine tests) were done for less than 40% and for 35% of the participants prenatal recommendations (except nutrition and breast feeding) were considered, Furthermore, all periodical prenatal care (except dentist visit) were done for about 60% -75% of disabled women and those who had Pap smear tests, breast self exam instructions, and breast physical exam by health staff were respectively 14%, 4.6% and 6.2%, besides, mammography was done for nobody in the group of more than 40 years old.Overall, according to the results it is estimated that only a small percentage of women with mobility impairment received reproductive health care. Therefore, further studies to explore obstacles faced by disabled women are recommended. Also it is suggested that available necessary services for cited citizens to be provided.

When we talk about third line in production, distribution and providing services, distinct and different thoughts of special activity comes to the mind. In other words that often come in the Iranina ancient literature, especially in poetry and prose is: “ Non disruptive brevity and verbosity, but equality” could be the most appropriate approach to provide information. Now this is about third line of health services which is topic of a combination in usage of strengths points of public or governmental services versus private services that can lead to improved services and provide novel standardized setting. So, some criterion and indicators must be present for goal achievements. Population are an important symbol that it would be preferable based on other providers or other data centers or groups will be matched. As we believe the humankind dignity cannot be separated from its existence, so he can reach where no other than Allah can reach it, as Saadi poet said: Dosen’ t seem wise man except God Look how far the degree of humanity We believe that in hospital and health services, the commercial law should not prevail. In medicine neither is graceful for physician nor hospitals and our suggested model in Sarem hospital is based on non-governmental or non-private pattern and on the other hand, this center can be influenced along with public institutions and NGOs, and charities based with the management of the specialists. With this view, and in the introducing of process in the previous years when prospect of third line of health services, we were planned two major and fundamental aims as below; Considering human dignity, providing standardized and high quality services, efforts in the use of coordinated equipment with modern technology, use of efficient knowledge and moral achievements, alleviate the pain and the healing of treatable patients in the terms of soul and spirit, reducing the costs of health care by offering material and legal solutions (such as insurance system). Noticing to the present human resources as a stable capital and reserves, creating job security, material and spiritual welfare supply suitable for staff (in the form of a large family in Sarem hospital), facilitate the growth and promotion of employees, providing the way for research opportunities which are the most important goals of third line of health services in Sarem foundation.

2Objective(s): Health tourism is a branch of the tourism industry that is of interest to many countries of the world due to its high demand and good income. Therefore, considering the importance of health tourism and the existing potential in Mazandaran province, this study was conducted with the aim of identifying and analyzing the factors affecting the development of the health tourism industry in Mazandaran province. Methods: The present study was conducted using a qualitative method with a content analysis approach. For this purpose, 17 health tourism industry experts and health tourists were selected using the purposeful sampling method. Semi-structured interviews were used to collect data. The interviews were conducted until we reached a point of theoretical data saturation. Results: The findings showed that the health tourism industry in Mazandaran province is affected by structural, process and contextual factors. The structural factors included issues related to infrastructures, potentials/attractions, institutional factors, and expert human resources for health tourism destination. The process factor included issues related to drivers of health tourism, provision of health services and destination situational factors. The contextual-field factor included issues related to sociocultural contexts, potentials and attractiveness of tourism, and economic capacity. Conclusion: Despite the importance of services related to health tourism and considering the increasing demand of this industry, travelers who travel to Mazandaran province need a variety of services, and the need to pay attention to quality service development in tourism destinations is evident. Therefore, the provision of other essentials for health tourists such as infrastructure, destination attractions, financial capacities, sociocultural conditions, human resources, situational factors are  the requirements for the development of this industry.

Background: The health system is recognized as one of the most fundamental pillars of societal development. Therefore, ensuring its resilience against sanctions, within the framework of resistance economy policies based on the capacities of Iranian medicine, is of great importance for the country. Hence, this study aims to explain the potential of Iranian medicine in achieving a resistance economy by strengthening and empowering the health system. Methods: This study is qualitative in approach and applied in purpose. Data were collected using library studies and semi-structured interviews. The statistical population consists of 12 experts in the field of health. The sampling method is purposive sampling. Two methods have been used for data analysis: qualitative content analysis and thematic analysis Results: The qualitative content analysis revealed that ensuring the resilience of the health system occurs through three main axes: food and drug security, reducing dependency on imports of health-related goods, and modifying consumption patterns. Furthermore, thematic analysis identified the following as key capacities of Iranian medicine in strengthening the health system: utilization of indigenous medical knowledge and local pharmaceutical production chains, designing a native nutrition model based on domestic raw materials and products, and implementing comprehensive preventive principles and simple, home-based treatments. Conclusion: The application and scientific development of Iranian medicine can play a key and effective role in reducing the vulnerability of the health system and enhancing its resilience within the framework of resistance economy policies.

Background: To estimate the prevalence and analyze factors associated with both public and private health services utilization in women population in a western district of Iran.Methods: A cross-sectional study with 1200 individuals aged 18-49 years carried out in different districts of Sanandaj City, western Iran, in 2012. The main outcome variable was use of health service in the previous 12 months. The in-dependent variables were age, education level, place of residence, marital and pregnancy status, household wealth, oc-cupation and duration time of employment, and rating of quality of health services.Results: The prevalence of public and private health services utilization were 60.8% [95%CI: 57.8, 63.8] and 53.8% [95%CI: 50.8%, 56.8%], respectively (P=0.001). After controlling other investigated factors using logistic regression; the academic educational level (OR=1.36, 95%CI: 1.03, 1.80; OR=1.76, 95%CI: 1.33, 2.33), residents of urban (OR=1.65, 95%CI: 1.10, 2.47; OR=1.60, 95%CI: 1.10, 2.42), pregnancy status (OR=2.38, 95%CI: 1.60, 3.55; OR=2.36, 95%CI: 1.61, 3.47), and high level of quality of health services (OR=1.61, 95%CI: 1.15, 2.27; OR=1.70, 95%CI: 1.20, 2.40) were found to be predictors of utilization of both public and private health care respectively. There was also statistically relation between high level of household wealth (OR=3.01, 95% CI: 2.00, 4.57) and private health services utilization.Conclusions: Prevalence of health services utilization varied according to the individual and social factors of population studied. Present study emphasizes the need to develop care models that focus on the characteristics and demands of the subjects.