The United Nations said Sunday that about 11,002 civilians have been killed or injured in Afghanistan in 2015, showing an increase of 4 percent over 2014. The country has been facing insurgency from militant groups like Taliban, while the Western forces are training the local troops in the country to bolster their defense against such groups.

The annual report from the U.N. said the increase in the casualty number is due to the fighting between government forces, backed by the Western allies, and the insurgent groups. The report, which said that 3,545 of the 11,002 were fatalities, added that the fighting has become more intense as the international troops are withdrawing from the country, according to Deutsche Welle, which cited agencies. Taliban and other insurgent groups were blamed for 62 percent of the civilian deaths and injuries in the country.

“The harm done to civilians is totally unacceptable,” Nicholas Haysom, the head of the U.N. Assistance Mission in Afghanistan, said, in a statement, according to Reuters.

The report added that ground engagements caused 37 percent of civilian casualties, while roadside bombings stood as the next reason at 21 percent. Suicide attacks reportedly killed 17 percent of people, while deaths and injuries among children increased 14 percent.

There was also a 28 percent spike in the casualties from pro-government security forces, as compared to 2014. The civilian casualties were also attributed to international military forces, mostly due to a U.S. airstrike at a hospital run by Doctors Without Borders that killed 42 people in October. The people killed in the October attack included staff, patients and family members while 43 people were injured.

The report said that 103 civilians were killed and 67 were wounded by international forces last year.

“The report references commitments made by all parties to the conflict to protect civilians, however, the figures documented in 2015 reflect a disconnect between commitments made and the harsh reality on the ground,” Danielle Bell, director of the U.N. human rights program in Afghanistan, said, according to Reuters. “The expectation of continued fighting in the coming months combined with the current levels of civilian casualties, demonstrate the critical need for immediate steps to be taken by all parties to the conflict to prevent harm to civilians.”

Since 2009, when the U.N. started recording the deaths and civilian casualties in Afghanistan, 59,000 deaths and injuries have been reported, according to Reuters.