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Report ID #0017
Status Approved HMO Name Skyda Health LTD
HMO Code HMO-003 State Gombe
Reporting Month October 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 1,478 89.58% Males Enrolled 487 32.95%
Females Enrolled 991 67.05% Active Enrollees 1,478 Vulnerable Groups Pregnant Women 446 30.18%
Under-5 Children 573 38.77% Persons with Disabilities 158 10.69%
Elderly (60+) 160 10.83% Others (incl. IDPs) 147 9.95%
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 1,478
Total Enrollee Visits 648 Enrollee Visit Rate (per 1,000) 438.43
B. Visit Type Mix (Facility Level) Total PHC Visits 648 100%
Total SHC Visits 0 0% C. Visit Type Breakdown OPD/Consultations 564 87.04%
Admissions/Inpatients 21 3.24% Deliveries 14 2.16%
Emergency 49 7.56% Other Visits 0 0%
A. Service Encounters Total Encounters (Total Services Utilized) 1,128 B. Access to Care Enrollees Accessing Care (Last 30 Days) 243
% Enrollees Accessing Care 16.44% C. Service Utilization Rate (SUR) Service Utilization Rate (%) 76.32% D. Preventive Care Services Total Preventive Services 88 % Preventive Rate (of Encounters) 7.8% Antenatal Care (ANC) 67 76.14%
Post Natal Care (PNC) 21 23.86% Immunization Services 0 0%
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)
564
50%
2
Basic Laboratory Tests/Investigations
224
19.86%
3
Treatment of Common Ailments (Malaria, Diarrhoea, Cough and Chest Infection)
184
16.31%
4
Pharmacy/Drug Prescription
211
18.71%
5
Hospital Admission (Basic Inpatient Care)
21
1.86%
F. Referral & Care Transitions Enrollees Referred 10
Referrals Completed 9 90% Referrals Denied 1
Back-Referrals 7 70% G. Disease Burden Among Enrollees Malaria 467
Respiratory Infections 28 Gastrointestinal Diseases 11
Hypertension 2 Diabetes 0
Maternal Conditions 14 Injuries/Trauma 27
Mental & Behavioral 0 Other Communicable Diseases 12
Total Other NCDs 226
Other NCD Name Number of Encounters
Typhoid
197
Skin Issues
12
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) ₦833.78 per encounter
Claims Management (FFS) Claims Submitted 3
Claims Processed 2 Claims Approved 2 66.67%
Claims Denied 1 Amount Submitted ₦295,888.00
Amount Paid ₦295,888.00 Amount Rejected ₦137,500.00
Fee-For-Service (FFS) FFS Received ₦716,666.67
FFS Spent ₦295,888.00 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 124
Total Respondents 136 Enrollee Satisfaction (%) 91.18% Complaints Management Complaints Received 167
Complaints Resolved 139 Complaint Rate (%) 11.30%
Complaints Redressed (%) 83.23% Complaints Channel Coverage Facilities with Complaints Channel 13
Facility Complaints Coverage Rate (%) 100.00%
PHC Facilities Submitted Data 9
% PHC Submission 100.00% SHF Facilities Submitted Data 2
% SHF Submission 50.00% Daily Data Submission PHC Facilities Submit Daily Data 9
% Daily Submission 100.00%
Challenges Encountered -Low OPD attendance Mitigation Measures -Low OPD: A sensitization was carried out through engaging with the traditional rulers, WDCs, facility in-charge, and also town criers.
Certified By Maspara Dan
Submission Date 03 Feb 2026
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