Health insurance (HI) is a social policy aims to raise the contribution of the community to implement a fair and humane care and protection of people's health. In the current context of Vietnam, due to a limitation. of health insurance system, the guidelines for the HI participation of the farmer group have not yet implemented. The participation of this group depends largely on their willingness and affected by factors of knowledge and attitude of the farmers themselves with health insurance. This study aimed to identify current status of HI participation and propose solutions to strengthen the voluntary of HI participation among farmers in Son Tay Town, Hanoi with specific objectives: (i) to describe current status of HI participation among farmers in Son Tay Town, Hanoi in 2012
(ii) to identify factors related to the HI participation among farmers in the study area. The study employed a cross-sectional descriptive study design combined quantitative and qualitative methods. Study period from 12/2011 - 8/2012. The study results showed that the HI participation rate is very low (20.4 percent). The reason most people did not participate mainly: financial difficulties (43.9 percent), complicated administrative procedures in HI healthcare and treatment (19.1 percent), not know the procedures to purchase health insurance (17.6 percent). The proportion of people having health insurance cards within one year was high (78.7 percent). Using health insurance cards in all healthcare visits was high (87.5 percent). Using services in public provincial and districted hospitals accounts for the majority (52.5 percent and 33.3 percent). Assessment of the quality of HI healthcare and treatment was not good (waiting period for long examination: 84.1 percent, pending registration: 55.6 percent, pending laboratory long: 40.3 percent). The attitude of doctors and medical staffs as well was low (25.4 percent). The adequation of drug is low (48.4 percent). Difficulties in referral procedures were high (90.5 percent). Men tended to be more participate than women. People in the elderly group, low education, low income, low knowledge about health insurance participated lower than the young group
highly educated, high income and knowledge about health insurance. Recommendations are to put forward to strengthen advocacy and mobilization largely for people in rural areas about interests, rights and obligations of the voluntarily in HI participation to increase the percentage of health insured people, and further progress roadmap to achieve 100 percent universal health coverage in 2015. The study was also a basis for the subsequent intervention studies aimed at increasing participation rates of HI in all subjects including farmers in the Son Tay town, Hanoi.