Report #0015 — Skyda Health LTD  |  November 2025
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  1. Administrative Information
Report ID#0015 StatusApproved
HMO NameSkyda Health LTD HMO CodeHMO-003
StateGombe Reporting MonthNovember 2025
LGAs CoveredBalanga, Dukku, Y/Debba
Submission Date03 Feb 2026 Submitted ByMaspara Dan
  2. Enrollment and Coverage
Target Enrollees1,650 Total Enrolled1,650 100%
Males Enrolled550 33.33% Females Enrolled1,100 66.67%
Active Enrollees1,650
Vulnerable Groups
Pregnant Women512 31.03% Under-5 Children652 39.52%
Persons with Disabilities162 9.82% Elderly (60+)162 9.82%
Others (incl. IDPs)162 9.82%
  3. Provider Network
Primary Health Care (PHC)
Target PHC Facilities9 PHC Accredited9 100%
Secondary Health Facilities (SHF)
Target SHF4 SHF Accredited4 100%
Total Contracted Facilities13
  4. Facility Visits
A. Summary
Active Enrollees1,650 Total Enrollee Visits1,065
Enrollee Visit Rate (per 1,000)645.45
B. Visit Type Mix (Facility Level)
Total PHC Visits1,026 96.34% Total SHC Visits39 3.66%
C. Visit Type Breakdown
OPD/Consultations1,020 95.77% Admissions/Inpatients24 2.25%
Deliveries5 0.47% Emergency0 0%
Other Visits16 1.5%
  5. Service Utilization
A. Service Encounters
Total Encounters (Total Services Utilized)1,040
B. Access to Care
Enrollees Accessing Care (Last 30 Days)355 % Enrollees Accessing Care21.52%
C. Service Utilization Rate (SUR)
Service Utilization Rate (%)63.03%
D. Preventive Care Services
Total Preventive Services200 % Preventive Rate (of Encounters)19.23%
Antenatal Care (ANC)12 6% Post Natal Care (PNC)0 0%
Immunization Services188 94% Family Planning Services0 0%
Nutrition/Health Education0 0% Other Preventive Services0 0%
E. Most Frequently Used Services
#ServiceNumber% of Total Encounters
1 Outpatient Consultations (OPD) 456 43.85%
2 Basic Laboratory Tests/Investigations 198 19.04%
3 Treatment of Common Ailments (Malaria, Diarrhoea, Cough and Chest Infection) 211 20.29%
4 Pharmacy/Drug Prescription 187 17.98%
5 Hospital Admission (Basic Inpatient Care) 24 2.31%
F. Referral & Care Transitions
Enrollees Referred8 Referrals Completed5 62.5%
Referrals Denied3 Back-Referrals4 50%
G. Disease Burden Among Enrollees
Malaria698 Respiratory Infections159
Gastrointestinal Diseases34 Hypertension12
Diabetes0 Maternal Conditions0
Injuries/Trauma11 Mental & Behavioral0
Other Communicable Diseases8 Total Other NCDs117
Other NCD NameNumber of Encounters
Typhoid 117
  6. Finances
Capitation
Facilities Paid Capitation9 69.23% Facilities Pending Capitation0 0%
Total Capitation Paid₦940,500.00 Total Capitation Pending₦0.00
Capitation-to-Utilization Ratio (CUR)₦904.33 per encounter
Claims Management (FFS)
Claims Submitted5 Claims Processed5
Claims Approved4 80% Claims Denied1
Amount Submitted₦371,410.38 Amount Paid₦287,640.38
Amount Rejected₦83,770.00
Fee-For-Service (FFS)
FFS Received₦716,666.67 FFS Spent₦287,640.38
Reserve Fund
Reserve Fund Received₦107,500.00 Reserve Fund Spent₦0.00
  7. Quality Assurance
Total Facilities Assessed13 Facilities Meeting QA Standard12
QA Compliance Rate92.31%
Periodic Quality Checks
Facilities with Completed Checks13 Total Accredited Facilities12
Periodic Check Coverage108.33%
Enrollee Satisfaction
Satisfied Enrollees137 Total Respondents158
Enrollee Satisfaction (%)86.71%
Complaints Management
Complaints Received208 Complaints Resolved198
Complaint Rate (%)12.61% Complaints Redressed (%)95.19%
Complaints Channel Coverage
Facilities with Complaints Channel13 Facility Complaints Coverage Rate (%)100.00%
  8. Data Management
PHC Facilities Submitted Data9 % PHC Submission100.00%
SHF Facilities Submitted Data3 % SHF Submission75.00%
Daily Data Submission
PHC Facilities Submit Daily Data9 % Daily Submission100.00%
  10–11. Corrective Actions, Challenges & Mitigation
Challenges EncounteredDifficulty to reach some clients as the phone numbers they give arent their own
Mitigation Measuresuse of community stake holders to rich out to the clients
  12. Certification & Attestation
Certified ByMaspara Dan Submission Date03 Feb 2026
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