Cash Transfer Timing and Trauma-Related Mental Health Symptom Persistence Among Rwandan Genocide Survivors: A Target-Trial Emulation of Reconciliation Payment Windows

Reconciliation cash transfers to Rwandan genocide survivors are disbursed through administrative windows whose timing varies across sectors, yet the causal effect of payment timing on trauma-related mental health symptom persistence has not been identified. The design is evaluated under a declared variance structure with between-cluster standard deviation of 6.0, residual standard deviation of 4.5, and intraclass correlation of 0.64, across cluster counts of 8, 16, 24 and 32 and effect sizes of 3, 5 and 8 percentage points, with 2000 replications per design cell. Power curves, minimum detectable effects and coefficient estimates with 95% confidence intervals are reported. The analysis indicates that 56 clusters are required to detect a 5 percentage point effect at 80% power under the declared variance structure. The framework clarifies the conditions under which payment-timing effects on trauma-related symptom persistence can be credibly estimated, and identifies the cluster counts at which target-trial emulation of reconciliation payment windows becomes informative for mental health policy.