Responding to the Law Commission's recommendations, the Ministry of Justice explained that "without certainty as to the offsetting savings which might be achieved, when set against current resource constraints it is not feasible to implement the proposals in full at this time".
It was also shown that it will be more feasible to implement the DFE-BICM-ID receiver in real time due to its lower memory and complexity requirements.
While this may raise questions about the extent to which an EHIS is feasible to implement in this low-resourced setting, there are several examples of EHIS that have been successfully implemented in other health services in sub-Saharan Africa using mobile technology [ 42, 43].
This algorithm was feasible to implement and resulted in increased detection of asymptomatic but clinically significant liver disease compared to traditional liver enzyme-based algorithms, including a 140% increase in observed cirrhosis prevalence.
Moreover we have demonstrated that this approach is feasible to implement, can be delivered at scale and is potentially pro-poor even when delivered within health systems of resource-limited country settings.
We have demonstrated this diagnostic approach is feasible to implement and acceptable to patients, with more than 95% of investigations occurring in the community setting and non-attendance rates for TE appointments of less than 5%.
This strategy will not be feasible to implement in current daily clinical practice because diaphragm dysfunction is mostly recognized after a prolonged time of CMV.
However, whether this simple assay would be feasible to implement and useful in a programmatic setting remains to be demonstrated.
Though objectively registered outcomes would be ideal, given the national-level scope of this study, it was not feasible to implement a third-party observer-driven study design.
In this study, we have shown that it is feasible to implement such a programme and that similar high proportions of children having valid measurements of subscapular and triceps skinfolds, as found for weight and height measurements can be obtained.
