Fighting between the Taliban and Pakistani forces intensified in February, with many civilians killed in air raids.

At least 372 Afghan civilians were killed and 397 injured as a result of cross-border violence between Taliban forces and the Pakistani military in the first three months of 2026, the United Nations has reported, with more than half the deaths attributed to air raids on a drug rehabilitation facility in Kabul.

The UN Assistance Mission in Afghanistan (UNAMA), which monitors civilian casualties in Afghanistan, said its report, released on Tuesday, was based on checks with three different independent sources. The latest quarterly figure, which is higher than the casualties recorded for the period by UNAMA since 2011, included 13 women, 46 children (31 boys and 16 girls) and 313 men.

Cross-border clashes between Afghanistan and Pakistan have escalated significantly since the Taliban returned to power in 2021, and exploded into “open war” at the end of February, according to Pakistan’s defence minister.

Islamabad accuses the Taliban government in Kabul of sheltering armed fighters, notably the Pakistan Taliban (also known by the acronym TTP), which is different from the group that governs Afghanistan. Afghan officials deny this and counter that Pakistan harbours hostile groups and does not respect its sovereignty.

The high proportion of men was attributed to the March 16 strikes on a Kabul drug treatment hospital, which admitted only male patients. At least 269 people were killed and 122 wounded in the attack, although “the real figure may be significantly higher”. Many bodies “were unrecognisable due to extensive burns”, according to the report.

UNAMA called on the warring parties to respect international law by refraining from targeting health facilities or from firing shells or grenades into civilian areas. In a written response, Pakistan insisted that its “actions were directed solely against terrorist and military infrastructure”.

“The leading cause of civilian casualties was air strikes (64 percent), with the remaining caused by indirect cross-border firing” and one “targeted killing” of an NGO worker, UNAMA said.

A female Afghan employee of an NGO in Nuristan was killed on March 19, during the festival of Eid al-Fitr, even though a ceasefire had been agreed a day earlier. “The NGO worker was shot in her right side and fell into the water and drowned with her three-year-old son,” the report said.

Since ceasefire talks took place in China in early April, Pakistan and Afghanistan have reportedly committed to avoiding any escalation. Incidents have decreased but have not stopped entirely. Seven civilians were killed and 85 wounded in shelling on April 27 at a university in Asadabad in Kunar province, according to Afghan authorities.