Community-Based Trauma Rehabilitation Funding Interruption and Mental Health Relapse in Post-Conflict Liberia: A Competing-Risks Analysis of Donor Transition Timing

Community-based trauma rehabilitation programmes in post-conflict Liberia depend on donor funding cycles that rarely align with the longitudinal course of trauma-related mental disorders. The framework specifies three transition-timing parameters—transition abruptness, transition notice period, and post-transition service continuity—and derives the conditions under which each parameter alters the cumulative incidence of relapse. The analysis draws on published evidence on trauma rehabilitation financing, mental health service disruption, and donor transition in Liberia and comparable post-conflict settings to populate the framework's parameters and to identify the estimands that a competing-risks analysis would target. The framework proposes that abrupt transitions elevate relapse incidence through two mechanisms: interruption of therapeutic contact and erosion of community-based peer support structures. It further proposes that notice period length moderates this effect, with longer notice permitting both provider-initiated step-down and participant-initiated care-seeking. The contribution is a specification of the estimands, assumptions, and data requirements for a competing-risks analysis of donor transition timing, together with a set of testable propositions that link transition parameters to relapse incidence. The framework is intended to inform the design of donor exit strategies and the evaluation of their mental health consequences.