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Report #0015

Skyda Health LTD - Gombe | November 2025

Approved
Back to List View Data
Total Enrolled
1,650
100% of target
Facilities
13
Contracted
Total Visits
1,065
Visit Rate: 645.45 Per 1,000
Claims Approved
4
80% approval rate
1. Administrative Information
Report ID:
#0015
HMO:
Skyda Health LTD
HMO Code:
HMO-003
State:
Gombe
LGAs Covered:
Balanga, Dukku, Y/Debba
Reporting Month:
November 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:
1,065
B. Visit Type Mix
Total PHC Visits:
1,026 96.34%
Total SHC Visits:
39 3.66%
C. Visit Type Breakdown
OPD/Consultation:
1,020 95.77%
Admissions/Inpatients:
24 2.25%
Deliveries:
5 0.47%
Emergency:
0 0%
Other Visits:
16 1.5%
5. Service Utilization
A. Service Encounters
Total Encounters (Total Services Utilized):
1,040
Total number of service interactions delivered, including multiple services within a single visit
B. Access to Care
Enrollees Accessing Care (Last 30 Days):
355
% Enrollees Accessing Care:
21.52%
C. Service Utilization Rate (SUR)
Service Utilization Rate (%):
63.03%
Total Encounters ÷ Active Enrollees × 100
D. Preventive Care Services
Total Preventive Services:
200
% Total Preventive Services Rate
19.23%
Preventive Service Types
Antenatal Care
12 6%
Post Natal Care:
0 0%
Immunization Services:
188 94%
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) 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%
Percentage of Total Encounters (1,040)
F. Referral & Care Transitions
Enrollees Referred:
8
Referrals Completed:
5 62.5%
Referrals Denied:
3
Back-Referrals:
4 50%
G. Disease Burden Among Enrollees

Number of Encounters by Disease Category

Malaria:
698
Respiratory Infections:
159
Gastrointestinal Diseases:
34
Hypertension:
12
Diabetes:
0
Maternal Conditions:
0
Injuries / Trauma:
11
Mental & Behavioral Conditions:
0
Other Communicable Diseases:
8
Other Non-Communicable Diseases
Disease Name Number of Encounters
Typhoid 117
Total Other NCDs:
117
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:
₦904.33
Fees for Service (Claims) Management
Claims Submitted:
5
Claims Processed:
5
Claims Approved:
4 80%
Claims Denied/Rejected:
1
Total Amount Submitted:
₦371,410.38
Total Amount Paid:
₦287,640.38
Total Amount Rejected:
₦83,770.00
Fee-For-Service (FFS)
Amount of FFS Received:
₦716,666.67
Amount of FFS Spent:
₦287,640.38
Reserve Fund
Amount of Reserve Fund Received:
₦107,500.00
Amount of Reserve Fund Spent:
₦0.00
7. Quality Assurance
Total Facilities Assessed:
13
Facilities Meeting QA Standard:
12
QA Compliance Rate (%):
92.31%
Periodic Quality Checks
Facilities with Completed Checks:
13
Total Accredited Facilities:
12
Periodic Check Coverage (%):
108.33%
Enrollee Satisfaction
Satisfied Enrollees:
137
Total Respondents:
158
Enrollee Satisfaction (%):
86.71%
Complaints Management
Complaints Received:
208
Complaints Resolved:
198
Complaint Rate (%):
12.61%
Complaints Redressed (%):
95.19%
Complaints Channel Coverage
Facilities with Complaints Channel:
13
Facility Complaints Coverage Rate (%):
100.00%
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

Difficulty to reach some clients as the phone numbers they give arent their own

Mitigation Measures

use of community stake holders to rich out to the clients

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