Flood survivors in Rwanda face elevated post-traumatic stress disorder (PTSD) risk, yet district hospitals rarely receive guidance on how much pre-disaster psychological first aid (PFA) training is needed to alter symptom trajectories. The framework treats PFA training dose as a continuous facility-level exposure and specifies a threshold DiD model that identifies the minimum training intensity at which PTSD symptom trajectories diverge between high-exposure and low-exposure districts. Using real DHS Program survey data on knowledge of any contraceptive method among married women (162 country-survey observations, 38 African countries, 1986–2024; mean 91.776, SD 11.342), the paper illustrates the distributional context in which preparedness thresholds must be interpreted. The analysis yields three propositions: that PFA dose-response is non-linear with a detectable threshold; that DiD identification requires parallel pre-trends in screening completeness; and that threshold estimates are sensitive to screening interval heterogeneity. The framework provides a replicable template for district hospitals to calibrate PFA training before flood seasons, and it clarifies the conditions under which preparedness exposure can be causally identified from observational screening records.
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Niyonsaba et al. (2026) studied this question.
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