Report #0016 — Skyda Health LTD | December 2025
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| Report ID | #0016 |
Status | Approved |
| HMO Name | Skyda Health LTD |
HMO Code | HMO-003 |
| State | Gombe |
Reporting Month | December 2025 |
| LGAs Covered | Balanga, Dukku, Y/Debba |
| Submission Date | 03 Feb 2026 |
Submitted By | Maspara Dan (Assistant coordinator, Gombe State.) |
| Target Enrollees | 1,650 |
Total Enrolled | 1,650 100% |
| Males Enrolled | 550 33.33% |
Females Enrolled | 1,100 66.67% |
| Active Enrollees | 1,650 |
| |
| Vulnerable Groups |
| Pregnant Women | 512 31.03% |
Under-5 Children | 652 39.52% |
| Persons with Disabilities | 162 9.82% |
Elderly (60+) | 162 9.82% |
| Others (incl. IDPs) | 162 9.82% |
| |
| Primary Health Care (PHC) |
| Target PHC Facilities | 9 |
PHC Accredited | 9 100% |
| Secondary Health Facilities (SHF) |
| Target SHF | 4 |
SHF Accredited | 4 100% |
| Total Contracted Facilities | 13 |
| |
| A. Summary |
| Active Enrollees | 1,650 |
Total Enrollee Visits | 840 |
| Enrollee Visit Rate (per 1,000) | 509.09 |
| |
| B. Visit Type Mix (Facility Level) |
| Total PHC Visits | 819 97.5% |
Total SHC Visits | 21 2.5% |
| C. Visit Type Breakdown |
| OPD/Consultations | 804 95.71% |
Admissions/Inpatients | 12 1.43% |
| Deliveries | 3 0.36% |
Emergency | 19 2.26% |
| Other Visits | 2 0.24% |
| |
| A. Service Encounters |
| Total Encounters (Total Services Utilized) | 942 |
| B. Access to Care |
| Enrollees Accessing Care (Last 30 Days) | 380 |
% Enrollees Accessing Care | 23.03% |
| C. Service Utilization Rate (SUR) |
| Service Utilization Rate (%) | 57.09% |
| D. Preventive Care Services |
| Total Preventive Services | 238 |
% Preventive Rate (of Encounters) | 25.27% |
| Antenatal Care (ANC) | 67 28.15% |
Post Natal Care (PNC) | 13 5.46% |
| Immunization Services | 158 66.39% |
Family Planning Services | 0 0% |
| Nutrition/Health Education | 0 0% |
Other Preventive Services | 0 0% |
| E. Most Frequently Used Services |
| # | Service | Number | % of Total Encounters |
|---|
| 1 |
Outpatient Consultations (OPD) |
404 |
42.89% |
| 2 |
Basic Laboratory Tests/Investigations |
178 |
18.9% |
| 3 |
Treatment of Common Ailments (Malaria, Diarrhoea, Cough and Chest Infection) |
186 |
19.75% |
| 4 |
Pharmacy/Drug Prescription |
165 |
17.52% |
| 5 |
Hospital Admission (Basic Inpatient Care) |
19 |
2.02% |
|
| F. Referral & Care Transitions |
| Enrollees Referred | 12 |
Referrals Completed | 7 58.33% |
| Referrals Denied | 5 |
Back-Referrals | 5 41.67% |
| G. Disease Burden Among Enrollees |
| Malaria | 461 |
Respiratory Infections | 42 |
| Gastrointestinal Diseases | 32 |
Hypertension | 4 |
| Diabetes | 0 |
Maternal Conditions | 7 |
| Injuries/Trauma | 27 |
Mental & Behavioral | 0 |
| Other Communicable Diseases | 14 |
Total Other NCDs | 283 |
| Other NCD Name | Number of Encounters |
|---|
| Typhoid |
245 |
| Skin Issues |
21 |
| Ear Infections |
17 |
|
| Capitation |
| Facilities Paid Capitation | 9 69.23% |
Facilities Pending Capitation | 0 0% |
| Total Capitation Paid | ₦940,500.00 |
Total Capitation Pending | ₦0.00 |
| Capitation-to-Utilization Ratio (CUR) | ₦998.41 per encounter |
| |
| Claims Management (FFS) |
| Claims Submitted | 7 |
Claims Processed | 7 |
| Claims Approved | 4 57.14% |
Claims Denied | 3 |
| Amount Submitted | ₦557,115.56 |
Amount Paid | ₦398,720.79 |
| Amount Rejected | ₦158,394.77 |
| |
| Fee-For-Service (FFS) |
| FFS Received | ₦716,666.67 |
FFS Spent | ₦398,720.79 |
| Reserve Fund |
| Reserve Fund Received | ₦107,500.00 |
Reserve Fund Spent | ₦0.00 |
| Total Facilities Assessed | 9 |
Facilities Meeting QA Standard | 9 |
| QA Compliance Rate | 100.00% |
| |
| Periodic Quality Checks |
| Facilities with Completed Checks | 9 |
Total Accredited Facilities | 9 |
| Periodic Check Coverage | 100.00% |
| |
| Enrollee Satisfaction |
| Satisfied Enrollees | 135 |
Total Respondents | 176 |
| Enrollee Satisfaction (%) | 76.70% |
| |
| Complaints Management |
| Complaints Received | 208 |
Complaints Resolved | 169 |
| Complaint Rate (%) | 12.61% |
Complaints Redressed (%) | 81.25% |
| Complaints Channel Coverage |
| Facilities with Complaints Channel | 12 |
Facility Complaints Coverage Rate (%) | 92.31% |
| PHC Facilities Submitted Data | 9 |
% PHC Submission | 100.00% |
| SHF Facilities Submitted Data | 3 |
% SHF Submission | 75.00% |
| Daily Data Submission |
| PHC Facilities Submit Daily Data | 9 |
% Daily Submission | 100.00% |
| Challenges Encountered | Issues with classifying Primary and Secondary services among enrollees
Rejecting the generic drugs given to them |
| Mitigation Measures | Further awareness was provided to the beneficiaries to help foster continuous engagement with the available services. |
| Certified By | Maspara Dan |
Submission Date | 03 Feb 2026 |
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