Community-Based Trauma Rehabilitation Peer Navigator Tenure and Mental Health Recovery in Post-Conflict Sierra Leone: A Multilevel Analysis of Network Cohesion Decay

Community-based trauma rehabilitation programmes in post-conflict settings depend on peer navigators who link survivors to services, yet the durability of the social networks that sustain these links remains poorly understood. Drawing on established scholarship on social network interventions, task-shifting, and collective trauma in Sierra Leone, the analysis specifies a multilevel model in which navigator tenure operates at the network level while individual recovery trajectories unfold at the survivor level. The framework proposes that network cohesion follows a curvilinear trajectory over navigator tenure, rising during early relationship formation, plateauing during mature operation, and declining as navigator embeddedness erodes through role fatigue, community expectations, and resource attrition. These dynamics imply that recovery outcomes are non-monotonic in navigator tenure, with optimal recovery occurring at intermediate tenure rather than at maximum continuity. The paper derives testable propositions, identifies boundary conditions, and specifies the data structures required for empirical estimation. By treating network cohesion as a time-varying multilevel construct rather than a static programme attribute, the framework reframes peer navigator continuity as a dynamic property requiring active maintenance rather than a fixed implementation input. The contribution is a specification of the mechanism linking navigator tenure to recovery, together with the measurement and modelling strategy needed to evaluate it in post-conflict health systems.