District Hospital Trauma Mortality Notification Timing and Post-Traumatic Stress Symptom Onset Among Bereaved Ethiopian Caregivers: A Target-Trial Emulation of Disclosure Windows

Bereaved caregivers in Ethiopian district hospitals often learn of a trauma death through delayed, informal, or staged disclosure, and the timing of that notification may shape subsequent post-traumatic stress symptoms. Power was estimated across 2000 replications per design cell for cluster counts of 8, 16, 24, and 32 and effect sizes of 3, 5, and 8 percentage points. The analysis characterises the operating characteristics of the design rather than reporting observational estimates. At 80% power, 54 clusters are required to detect a 5-percentage-point effect. The framework specifies disclosure windows as time-anchored eligibility regimes, aligns them with caregiver symptom trajectories, and identifies the assumptions under which the before-after-control-impact estimator recovers a causal contrast. The contribution is a design template for causal inference on notification timing in low-resource trauma settings, with explicit boundary conditions and a power calculus that anticipates the clustering of bereavement outcomes within facilities.