In developing countries, traditional healers often have the role of being the primary health care providers for their communities [1–3]. In addition to traditional birth attendants (TBAs), there are distinct groupings of traditional healers that provide primary health care in communities, in different forms based on their skill level, their accessibility, and whether they underwent lengthy apprenticeships or a spiritual "calling" to their role [4–6].
Although many traditional healers are herbalists, this is not the only way traditional health care is practiced. Some call upon the ancestral spirits or perform exorcism to treat an illness, yet the herbalist may also incorporate this spiritual aspect in diagnosing the patient's illness [3, 5, 7]. Faith healers may utilize prayer, touch, and ointments in their healing rituals. There are also healers who combine Islamic medicine, and will invoke verses of the Koran and/or use astrology in the healing process .
The services of a traditional healer may be sought in cases where the illness is considered 'native' in origin. However, if the illness is considered to have a foreign origin, a Western medical provider may be consulted, out of the belief that they will be more familiar and have better treatment. The treatment is determined as specifically relating to the source of the illness, whether worldly or other-worldly. The use of traditional healers is widespread and accepted in most Haitian communities. Twenty-three percent of mothers go to traditional healers when their children are sick .
A Presidential decree of April 4, 2003 recognized Vodou as a bonafide religion in Haiti. With regard to the decree, Vodou chiefs, temple officials, officials at any sacred site, as well as all Vodou organizations or associations were empowered to file a request for recognition by the Ministry of Culture and Religious Affairs. It is possible for people in Haiti to belong to a mission religion such as Catholicism or Protestant Christianity but still practice Vodou [9, 10].
According to the World Health Organization (WHO), the two public health interventions that have had the greatest impact of the world's child health are clean water and vaccines. In light of this fact the importance of encouraging vaccination in Haiti is obvious benefit. Vaccinations against tuberculosis, diphtheria, pertussis, tetanus, measles, and polio have dramatically reduced the burden of death and disease from infectious diseases [11, 12]. However, vaccination services continue to be under-utilized, especially in developing nations. Almost two million children still die each year from vaccine-preventable infectious diseases . In Haiti, more than 138,000 children under five years of age die of preventable diseases annually; 60% of those who survive may fail to develop adequately . The major causes of mortality among children under five years old are diarrhea, malnutrition, measles and malaria. Furthermore, because measles enhances deficiency in vitamin A, it continues to be an important cause of blindness . Only 30% of Haitian children 12–23 month old are fully vaccinated. There appears to be no sex or urban versus rural differences in vaccination prevalence in the country .
Over the years, the World Health Assembly has adopted a number of resolutions encouraging the study of the potential usefulness of traditional medicine including evaluation of practices and examination of safety and efficacy of remedies used. The WHO also advocates for the education and information dissemination of the public about proven traditional health practices [16–18]. Globally, traditional healers have been reported to offer treatments for hypertension,  cancer,  AIDS,  tuberculosis, [22, 23] malaria, [3, 24, 25] sexually transmitted infections,  epilepsy,  and infertility . However, there is paucity of studies on the role of traditional healers in vaccination. The purpose of this study was to examine the association between the use of traditional healers by mothers and child vaccination.