Introduction: Nepal was hit hard by COVID-19 pandemic and is still struggling with its implications for individuals, societies, and health systems. We applied Interrupted Time Series (ITS) analysis to see if the government's decision to end two nationwide lockdowns had an impact on the average daily new cases of COVID-19 reported in Nepal.   Method: ITS analysis on daily new cases of COVID-19 was performed for first and second nationwide lockdown on data of Nepal from data depository for 2019 Novel Coronavirus Visual Dashboard operated by Johns Hopkins University Center for Systems Science and Engineering. Impact of ''ending nationwide lockdown'' and possible associated factors were investigated. Result: The impact of removing first nationwide lockdown contributed to statistically significant rise of an average difference of 899 daily new cases due to community transmission of COVID-19. During second lockdown, even after imposing lockdown, cases overwhelmed existing healthcare system due to high infectivity of new Delta variant followed by a lack of adherence to public health measures and delayed decision to impose lockdown due to economic reasons. Whereas significant decline of cases was observed with an average difference of 2970 daily new cases after ending second nationwide lockdown mostly due to vaccine acceptance.   Conclusion: First lockdown was imposed early due to uncertainty about progression of disease, curative measures and unavailability of vaccines. Ending of first lockdown was done untimely due to economic reasons and festive seasons.  The unusual decline in cases after ending second lockdown could be contributed to increased vaccination in the country.

Introduction: One school one nurse is a new program in Nepal aiming to improve students' health. This study aimed to find utilization of school nurse service and associated factors in selected schools of Kathmandu district using mixed methods approach.   Method: Study included Kirtipur Secondary School and Shivapuri Higher Secondary School. It used concurrent triangulation mixed method design. Quantitative phase included survey among 30 students, 15 from each school while qualitative phase had 4 in-depth interviews and 2 key informant interviews. Fisher’s exact test and Braun and Clarke’s six-step thematic analysis based on socio-ecological model were used to analyze factors associated with service utilization quantitatively and qualitatively. Results were triangulated using convergent, divergent and expansive findings.   Result: Out of 30 participants, 27(90%) had ever contacted to school nurse for any health issue. Student's visit to school nurse for mental health issue was the only factor found significantly associated with frequency of visit. Qualitative analysis explored many associated factors at different socio-ecological level. No sex wise variation in sharing sensitive health issue with school nurse was convergent finding. Divergent findings were identified regarding factors like health issues to visit school nurse, motivator, perceived privacy and sex.  Expansive finding was that a school nurse appointed in a school also served nearby schools beyond her job description.   Conclusion: An effort from individual level to policy level is needed to resolve hindering factors of school nurse service utilization and maintain the promoting ones.