In the recent past, the rate of syphilis infection among the US population has been increasing drastically, which has also lead to the increase of syphilis cases among the pregnant women. The increasing rate of pregnant women suffering from syphilis leads to increased chances of the infants contracting congenital syphilis which is life-threatening and leads to child mortality immediately after birth or a few months after birth (( Harnisch, 2012) . For example, based on statistics that were released by the World Health Organization in 2008, the facts indicated that 1.4 million women were suffering from syphilis globally among whom 80% were attending the prenatal clinic ( Shannon et al., 2014) . Additionally, the statistic further revealed that congenital syphilis accounts for approximately 40% of the total mortality rate among the newborns ( Hawkes et al., 2013) . The rate of transmission from mother to child among women who did not attend the prenatal care resulted in about 70 to 100% in both primary and secondary stages of maternal diseases. Congenital syphilis can be described as a severe infection, which leads to disability and which are life threatening to infants. The infection is caused by Treponema pallidum bacteria which are transferred from the mother to the child during the prenatal stage and birth ( Shannon et al., 2014) . Statistics indicate that approximately half of the children born with syphilis die shortly after birth which in turn has been increasing the mortality rate among the infants ( Buttaro, 2013) . Despite the fact that syphilis rates have reduced in the population, it is important to state that there are still cases of increased syphilis among specific groups of individuals such as homosexual. Importantly, despite the fact that most of the developing countries have managed to control syphilis among its population, the developing countries and especially those that score high in poverty have high syphilis prevalence, which explains the high mortality rate for children born to mothers suffering from the condition.
Owing to this life-threatening infection for both the pregnant mothers and the developing infants, the question of the role of primary health care in preventing the transmission of the infection from the mother to the child has questions. In this case, the knowledge of the primary health care providers and how they react to syphilis cases among pregnant women is key in controlling the mortality rates that arise from congenital syphilis ( Harnisch, 2012) . Additionally, the role of educational intervention in primary health care and how it can be used to prevent the transmission of syphilis from mother to the growing child in the womb has also raised concern about its effectiveness in achieving this goal. Congenital syphilis poses a health risk to the unborn child as it can result in physical and mental disabilities and also leading to stillbirth, miscarried as well as the birth of premature children ( Hawkes et al., 2013) . Based on the past surveys and literature regarding the role of an educational intervention for primary caregivers on matters related to congenital syphilis and other health condition. Literature indicates that majority of the primary health care providers provided with the education they were able to practice the taught skills which in turn aided in reducing congenital syphilis as well as other health condition ( Harnisch, 2012) . Therefore, education intervention is an important tool in controlling and reducing the transmission of congenital syphilis from mother to child during prenatal growth and development when it is impacted on the primary health care providers.
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Relevance of the project
The research study aims at establishing the role of educational intervention in adding the primary caregivers in reducing and controlling the rates of congenital syphilis which is transmitted from the mother to the child during the prenatal period or during birth and which is a major cause of mortality deaths among infants. The study will enable the health care providers to understand the importance of educational intervention in impacting necessary knowledge and skills to deal with the increasing cases of congenital syphilis. The rates of congenital syphilis vary from one year to the other, whereby in one year there are a few cases of the infection, but in the next, the cases increase rapidly. Providing up to date information regarding the status of congenital syphilis will enable the primary caregivers to maintain a record of progressive reduction of the infection. Finally, the study will provide detailed evidenced based on previous effects of educational intervention for primary caregivers in dealing with syphilis infections from the mother to the child.
Background information
Congenital syphilis accounts for approximately 40% of the mortality children born of mothers with syphilis ( Buttaro, 2013) . The statistics are relatively high bearing in mind that there are other causes of infant deaths which score relatively low when compared to congenital syphilis. As a result, education intervention has been viewed and proved to be an effective approach that can be used by the health industry to reduce congenital syphilis. Previous studies indicated that providing health education to the health providers, the patients and their family have effectively managed to reduce some of the health conditions. Additionally, based on a survey that was carried out in Londrina, Paraná health sector between 2013 and 2014 to determine the effectiveness of the educational intervention on health providers in regards to congenital syphilis. The survey found out that the mean number of correct responses among the primary health providers after the intervention was approximately 53% to 74.3% ( Shannon et al., 2014) . Additionally, after the intervention, 92.6% of the primary health care providers adhered to their professional training and skills in treating pregnant women which in turn lead to significant reduction in infant mortality resulting from congenital syphilis ( Hawkes et al., 2013) . As a result, education intervention that aims at impacting knowledge and skills on the primary health care providers have been considered as one of the most effective strategies for dealing with some health conditions among them congenital syphilis.
Collection and Appraisal of Evidence
Education intervention creates awareness and provides additional knowledge to the primary caregivers who in turn aid in the prevention, diagnosis, and treatment of congenital syphilis. Literature indicates that educational intervention for congenital syphilis has previously impacted positively on the healthcare providers regarding their professional response, diagnosis, and management of gestational as well as congenital syphilis. Existing data based on already conducted survey indicated that despite the fact that the prenatal care is essential in preventing congenital syphilis. Most of the health providers were reluctant to start syphilis medication on pregnant women, but after attending the education intervention program. The caregivers were in a position to determine early signs of syphilis among pregnant women as well as providing appropriate intervention which in turn aided in reducing the total number of infants' deaths that arose from vertical transmission of congenital syphilis.
Information indicating the positive impact of educational interventions in improving the quality of primary health care providers is essential for this paper as it supports the thesis. The thesis focuses and emphasizes on the importance of educational intervention in helping the primary health care providers in acquiring necessary and applicable knowledge and skills to prevent effectively, control and manage syphilis cases among pregnant women. The approach will in turn aid in reducing the congenital syphilis cases among infants which is one of the contributing factors toward increased mortality rate. The information is valid because it is built on already existing literature. It is also important to indicate that the information is valid because the data from the survey that have already been carried out is consistent with previous research findings on the same topic. The data is also supported by adequate data that have been researched on by professional researchers among them individuals working in the health sector. The validity of the information is further reinforced by the fact that it is documented in books as well as the sources of the information are well known, such as secondary data as well as from surveys. Lastly, the research findings are also made available to the readers and to untreated researchers who might be interested in carrying further research to determine the validity of the information.
Theoretical Framework
Despite the fact that syphilis cases have been declining from one year to the other leading to fewer cases of syphilis infection among the world population, it is important to indicate that there are still individuals who are suffering from the infection as well as the fact that there are new reported cases of infection. It is also important to indicate that syphilis is a life-threatening infection that can lead to serious health problems and if not well intervened it leads to death ( Hawkes et al., 2013) . Congenital syphilis through a rear infection in the twenty-first century, it is important to indicate that it is still claiming lives of infants’ right after birth or during prenatal development ( Buttaro, 2013) . Congenital syphilis has adverse health effects on both the mother and the child as it leads to inappropriate growth and development of the child while still in the womb, it can lead to miscarriage, stillbirth as well as the death of infants. As a result, the health institutions have worked with health researchers to determine possible ways of reducing the 40% deaths of children that result from congenital syphilis ( Buttaro, 2013) .
Previous research findings indicate that educational intervention plays an important role in improving the screening, diagnosis, treatment, and management of syphilis which in turn helps in reducing the vertical transmission of the infection from the mother to the child. It is important to indicate that 80% of negative pregnancy outcomes results from women with active syphilis condition among the adverse effects include 40% of stillbirth, 20% perinatal deaths, and 20% of severe neonatal infection ( Kuznik et al., 2013) . Additionally, 25-75% of infants exposed to syphilis is likely to contract congenital syphilis, and 10-12% of children die from untreated cases of syphilis ( Hawkes et al., 2013) . The data portrays a large number of children who are at risk of contracting congenital syphilis which is life threatening to their lives and can lead to serious health problems and also died after the child is born. However, the literature indicates that by providing up to date information on the current status of syphilis in a population as well as providing adequate and improved training for primary caregivers can significantly reduce the cases of child mother infection as well as reducing the mortality rate for infants exposed to syphilis during pregnancy ( Buttaro, 2013) . Additionally, congenital syphilis remains as one of the risk factors that cause neurological, musculoskeletal disability, as well as infants death especially in the developing nation despite the fact that the screening procedure and medication for syphilis are cost effective as it is cheap, hence, making it affordable to most of the population( Kuznik et al., 2013) . However, the screening procedures, diagnosis, and treatment of syphilis among pregnant women who attend antenatal clinics have been relatively low despite the global policy that requires the health practitioners to screen and provide necessary medication to pregnant women suffering from syphilis. Such errors within the health sector can be corrected through the educational intervention which encourages health professionals to be professional in their day to day health care services as well as creating awareness to the public of the need to be a screen of such health conditions ( Harnisch, 2012) .
Educational intervention plays a major role in reminding and impacting knowledge on how the health practitioner should respond to syphilis condition and how to manage the condition in an attempt to ensure safe and normal growth and development of the child in the womb. It has been point out by previous literature that educational intervention increases the primary health care efficiency due to increased application of learned knowledge and skills ( Kuznik et al., 2013) . Additionally, education intervention enables the primary health workers to act, respond and handle health conditions in a professional way which in turn helps in effectively managing and reducing some of the health conditions such as sexually transmitted diseases which also include syphilis. Additionally, education intervention also increases knowledge to the health professional regarding syphilis which in turn enables the health professions to understand the infection as well as enabling them to collectively develop new approaches to deal with the problem which in turn helps in reducing the mortality rate of children complications that arise from congenital syphilis (( Kuznik et al., 2013) .
Hypothesis
Education intervention in the health sector has proved to be effective in enhancing the primary health care service delivery. Additionally, the educational intervention has also been effective in helping the caregivers reduce as well as effectively managing congenital syphilis. Therefore, education intervention for primary caregivers working to reduce congenital syphilis is the most appropriate approach to apply.
Research design
The research is a case study which will be evaluating the effectiveness of the educational intervention for primary caregivers in the congenital syphilis department of the health sector. The case study will build on already existing literature regarding the educational intervention approach for primary health care providers with the aim of significantly reducing congenital syphilis cases.The case study will utilize the already existing secondary data to support the thesis as well as to either prove the hypothesis right or wrong. The case study will also apply survey techniques, whereby a survey will be carried out in one of the health facilities before and after the educational intervention approach. So as to determine the effectiveness of the approach among the primary care providers, the survey will employ sampling techniques. Whereby the participants of to be involved in the study will be sampled from a large group of primary health care providers who have in the past and will still be handling pregnant women who had suffered or are suffering from syphilis. The sampling will be systematic whereby primary health professionals will be selected on their experiences with syphilis patients as well as those who have undergone education intervention while still in their profession.
Data collection
The process of collecting data will involve questioners who will be presented to the participants before being subjected to the education intervention program, and another questioner will also be presented to the participants after the intervention. The two types of questioners will help in acquiring adequate data regarding the primary caretaker's activities before and after the program in an attempt to determine whether the program had any effect on the health providers' day to day operation and how it affected them. The two types of questioners will have a maximum of fifteen question whereby five of the questions will have a closed structure while the other ten will be open, which will allow the researcher to acquire adequate data from the participants. The questioners will also ensure the participant's identity is not revealed so as to enable them to provide genuine data without fear of being held responsible for providing accurate information that the health institution might wish to remain a secret.
Additionally, the case study will also make use of secondary data. Secondary data will compose of already existing literature about the impact of the educational intervention for primary health care providers those involves in treatment and management of patients suffering from congenital syphilis.
Additionally, the case study will also use observation in data collection which will involve observing how the caregivers respond and treat patients with syphilis, especially pregnant women before and after the education intervention program. The observations will be carried out in a natural setting whereby the researcher will observe the primary caregivers providing care to the patients without interfering with the patient's roles in any way.
An oral interview will also be used in collecting data to from the patients as well as the primary caregivers before and after the intervention program to determine whether or not the approach was effective in increasing the caregiver's efficiency in dealing with pregnant women. The oral interview will enable the researcher to acquire adequate data that is clear. During the oral interview, the participants have the opportunity to clarify information which will, in turn, help the researcher in acquiring the actual data as well as adequate information that will be used in making informed decisions and conclusion regarding the status of the topic.
Funding
The researcher will mainly fund the resources that will be utilized in the research study. The researcher will cater for all the expenses that will be involved in the research process such as acquiring the questioners as well as the cost of traveling to the health facility to make observations.
Dissemination
The research findings will be distributed to the health sectors through soft copies as well as hard copies. The soft copies will enable easy sharing of information between health facilities as well as exchange of the information within the same health institution among different departments. Additionally, the information will also be shared through the health magazines as well as the journals. Using the magazines and journals will enable the general public to have access to the information which will in turn aid in influencing them to support educational intervention as an effective approach to dealing with some of the health conditions of them congenital syphilis.
References
Buttaro, T. M. (2013). Primary care: A collaborative practice . St. Louis, Mo: Elsevier/Mosby.
Harnisch, D. R. (2012). Prenatal care . Philadelphia: Saunders.
Hawkes, S. J., Gomez, G. B., & Broutet, N. (2013). Early antenatal care: does it make a difference to outcomes of pregnancy associated with syphilis? A systematic review and meta-analysis. PloS one , 8 (2), e56713.
Kuznik, A., Lamorde, M., Nyabigambo, A., & Manabe, Y. C. (2013). Antenatal syphilis screening using point-of-care testing in Sub-Saharan African countries: a cost-effectiveness analysis. PLoS Medicine , 10 (11), e1001545.
Shannon, G. D., Alberg, C., Nacul, L., & Pashayan, N. (2014). Preconception healthcare and congenital disorders: a systematic review of the effectiveness of preconception care programs in the prevention of congenital disorders. Maternal and child health journal , 18 (6), 1354.
