Hi Desta,
The design of your TSFP programme will determine what is, or is not, acceptable. This will be determined by your admission and discharge criteria and the purpose / target group of the TSFP.

If the overall non-response rate is very low (and has been reported accurately) then it is likely that the programme as a whole is achieving its objectives - as long as the defaults, deaths and transfers to OTP are also low (i.e. the TSFP is achieving a high cure rate).

The definition of the case as being 'non-responder' will be determined by the national or agency treatment guidelines you are using. In the context of those guidelines, the long response time for this individual should be investigated starting with a case review. For example:
- What is the median length of stay for all cases in the programme?
- Was MAM correctly diagnosed for this individual?
- Is the supplementary food being used appropriately?
- Is there an adequate food ration in the household?
- Does the individual have an undiagnosed illness?
- Is the attendance to the treatment centre adequate?
- Has there been a static weight for some time which has not yet been noticed or addressed?
- Are the TSFP distribution staff able to detect minor illnesses?
- Are there protocols to assist staff in the early referral of cases not responding to treatment?

For some NGO programmes the definition of non-responder would be after 4 months (120 days) in a TSFP. In this case the individual would not yet be a 'non-responder' and would still have time to respond to treatment. However it suggests that the investigation of the cause should happen immediately (including home follow up) since there would be only 21 days left for the individual to achieve 'cured' criteria in a programme with monthly distributions.

In this individual case you might, as a programme manager, consider extending the admission period of the individual for another month to allow the investigation of the cause of the poor response.