Beirut : Russian airstrikes killed at least 23 civilians on Tuesday in northwestern Syria, as renewed violence tightened the noose around the country’s last major rebel-held bastion and deepened an already dire humanitarian crisis.

Retaliatory rocket attacks blamed on rebels and jihadists killed three more civilians in the nearby government-held city of Aleppo, state news agency SANA said.

The spike in violence in the neighboring provinces of Aleppo and Idlib follows so far unsuccessful diplomatic attempts to reduce hostilities in the flashpoint region, with the latest truce, in theory, going into effect less than two weeks ago.

Most of Idlib and parts of Aleppo province are still controlled by factions opposed to President Bashar al-Assad’s regime, including a group that includes onetime members of Al-Qaeda’s former Syria franchise.

The Damascus regime, which controls around 70 percent of the country after nearly nine years of war, has repeatedly vowed to recapture the region.

Idlib hosts at least three million people, many of whom have fled other parts of the country and are in need of urgent humanitarian assistance.

On Tuesday, airstrikes by regime ally Russia on a rebel-held zone of Aleppo’s western countryside killed eight members of the same family, said the Syrian Observatory for Human Rights.

Six children were among those killed in the raid in Kfar Taal village, where three girls died in strikes a day earlier, according to the Britain-based monitor.

Another 15 civilians were killed in Russian air raids on western Aleppo and a southern region of Idlib, bringing the day’s death toll to 23, including 13 children.

“Over the past three days, the bombardment on Idlib and its surroundings, including in western Aleppo, has been exclusively Russian,” said Observatory head Rami Abdel Rahman.

“They want to push rebels and jihadists away from the city of Aleppo and from the motorway linking Aleppo to Damascus,” SANA said rebel rocket fire on Tuesday also killed two women and a child in Aleppo city.

The surge in violence comes despite a ceasefire announced by Moscow earlier this month that never really took hold.

Last Thursday, Russia denied launching any combat operations in the region since the start of the ceasefire earlier this month.

Thousands of Russian troops are deployed across Syria in support of the army, while a contingent of Russian private security personnel also operates on the ground.

Moscow’s military intervention in 2015, four years into the Syrian conflict, helped keep Assad in power and started a long, bloody reconquest of territory lost to rebels in the early stages of the war.

Abdul Rahman said the latest spate of airstrikes could be a prelude to a land offensive in western Aleppo province, as the regime and its allies continue their drive to shrink the last opposition-held pocket.

“The regime has massed reinforcements on the outskirts of the city of Aleppo,” Abdel Rahman said.

The violence in northern Syria is escalating an already dire humanitarian situation, with aid groups warning of displacement on an unprecedented scale.

According to the UN humanitarian coordination agency OCHA, almost 350,000 people have fled their homes since December 1, mainly northwards from southern Idlib, which has borne the brunt of the airstrikes.

The International Rescue Committee has warned another 650,000 people, mostly children and women could be forced from their homes if the violence continues.