District Hospital Trauma Consent Complexity and Mental Health Follow-Up Dropout Among Ugandan Caregivers: A Regression Discontinuity Analysis of Consent Form Literacy Thresholds

Informed consent for trauma care in Ugandan district hospitals is typically obtained from caregivers under acute stress, using forms whose readability often exceeds the literacy of the person signing them. Because no primary data were collected, the study is framed as a methodological and analytical proposal: it specifies a regression discontinuity design that treats the gap between form readability and caregiver literacy as the assignment variable, with a threshold at the point where comprehension fails. The paper draws on the DHS Program indicator 'Knowledge of any method of contraception among married women' (FP_KMET_W_ANY) across 38 African countries and 162 country-survey observations from 1986 to 2025 (mean 91.776, SD 11.342, range 57.80 in Chad to 99.90 in Eswatini) to illustrate the distributional properties that a literacy-threshold analysis must accommodate. The proposed design would permit estimation of a local average treatment effect of consent incomprehension on follow-up dropout, but the paper reports no empirical estimates of that effect. The contribution is a specification of how consent-form literacy thresholds can be operationalised as a regression discontinuity, together with an assessment of the identification assumptions that such a design would require in district hospital settings.