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Report #0016

Skyda Health LTD - Gombe | December 2025

Approved
Back to List View Data
Total Enrolled
1,650
100% of target
Facilities
13
Contracted
Total Visits
840
Visit Rate: 509.09 Per 1,000
Claims Approved
4
57.14% approval rate
1. Administrative Information
Report ID:
#0016
HMO:
Skyda Health LTD
HMO Code:
HMO-003
State:
Gombe
LGAs Covered:
Balanga, Dukku, Y/Debba
Reporting Month:
December 2025
Submission Date:
03 Feb 2026
Status:
Approved
2. Enrollment and Coverage
Target Enrollees:
1,650
Total Enrolled:
1,650 100%
Males:
550 33.33%
Females:
1,100 66.67%
Pregnant Women:
512 31.03%
Under-5 Children:
652 39.52%
Persons with Disabilities:
162 9.82%
Elderly (60+):
162 9.82%
Others
162 9.82%
Active Enrollees:
1,650
Gender Distribution
Vulnerable Groups
3. Provider Network
Target PHC Facilities:
9
PHC Accredited:
9 100%
Target SHF:
4
SHF Accredited:
4 100%
4. Facility Visits
Total Enrollee Visits:
840
B. Visit Type Mix
Total PHC Visits:
819 97.5%
Total SHC Visits:
21 2.5%
C. Visit Type Breakdown
OPD/Consultation:
804 95.71%
Admissions/Inpatients:
12 1.43%
Deliveries:
3 0.36%
Emergency:
19 2.26%
Other Visits:
2 0.24%
5. Service Utilization
A. Service Encounters
Total Encounters (Total Services Utilized):
942
Total number of service interactions delivered, including multiple services within a single visit
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%
Total Encounters ÷ Active Enrollees × 100
D. Preventive Care Services
Total Preventive Services:
238
% Total Preventive Services Rate
25.27%
Preventive Service Types
Antenatal Care
67 28.15%
Post Natal Care:
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
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%
Percentage of Total Encounters (942)
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

Number of Encounters by Disease Category

Malaria:
461
Respiratory Infections:
42
Gastrointestinal Diseases:
32
Hypertension:
4
Diabetes:
0
Maternal Conditions:
7
Injuries / Trauma:
27
Mental & Behavioral Conditions:
0
Other Communicable Diseases:
14
Other Non-Communicable Diseases
Disease Name Number of Encounters
Typhoid 245
Skin Issues 21
Ear Infections 17
Total Other NCDs:
283
6. Finances
Capitation
Total Facilities Paid Capitation:
9 100.00%
Facilities Pending Capitation:
0 0.00%
Total Amount of Capitation Paid:
₦940,500.00
Total Amount of Capitation Pending:
₦0.00
Capitation to Utilization Ratio:
₦998.41
Fees for Service (Claims) Management
Claims Submitted:
7
Claims Processed:
7
Claims Approved:
4 57.14%
Claims Denied/Rejected:
3
Total Amount Submitted:
₦557,115.56
Total Amount Paid:
₦398,720.79
Total Amount Rejected:
₦158,394.77
Fee-For-Service (FFS)
Amount of FFS Received:
₦716,666.67
Amount of FFS Spent:
₦398,720.79
Reserve Fund
Amount of Reserve Fund Received:
₦107,500.00
Amount of Reserve Fund Spent:
₦0.00
7. Quality Assurance
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%
8. Data Management
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.

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