A UN panel says it is "highly probable" that government forces were behind attacks last year on four civilian facilities in northwestern Syria.
The inquiry also found it "probable" that a deadly attack on a Palestinian refugee camp in Syria's Aleppo was carried out either by armed opposition groups or by Hayat Tahrir al-Sham, an extremist alliance formerly known as Nusra Front.
Bashar Assad's regime, backed by Russia, began an offensive early last year on the last major opposition stronghold in northwest Syria. Russia and Syria have said their forces do not target civilians or civilian infrastructure.
A summary of the report by the board of inquiry said it was "highly probable" the Syrian government or its allies carried out the airstrikes on the following facilities, although it noted that the evidence was not sufficient to reach a conclusive finding: Martyr Akram Ali Ibrahim al-Ahmad Secondary School in Madiq Castle, Hama province, on 28 April 2019; Rakaya Primary Health Care Centre in Rakaya Sijneh, Idlib province, on 3 May 2019; Kafranbel Surgical Hospital in Kafranbel, Idlib, on 4 July 2019; and Ariha Protection Centre in Ariha, Idlib, on 28 July 2019.
The board said it was "plausible" that damage to the Kafr Nabutha Primary Health Care Centre and Surgical Unit in Kafr Nabutha, Hama province, on 7 May 2019 was attributable to the Syrian government and its allies.
The Russian and Syrian missions to the United Nations did not immediately respond to a Reuters request for comment on the summary of the UN report, which Secretary-General Antonio Guterres submitted to the 15-member Security Council on Monday.
"The impact of the hostilities on civilian and humanitarian sites in northwest Syria is a clear reminder of the importance for all parties to the conflict to observe and ensure respect for international humanitarian law," Guterres wrote in a letter to the council.
"According to numerous reports, the parties have failed to do this," he said.
Under pressure from two-thirds of the Security Council, Guterres announced in August that the world body would investigate attacks on UN-supported facilities and other humanitarian sites in northwest Syria.
The locations of the UN-supported facilities and other humanitarian sites had been shared with the warring parties in a bid to protect them. However, the United Nations has questioned whether it made them a target.
Guterres noted that the members of the board of inquiry were unable to visit Syria to investigate as the regime did not respond to repeated requested for visas. The attacks investigated by the board took place in April, May and July.
Fighting has calmed in the northwestern region after Turkey, which backs factions opposed to Assad and ramped up its deployment earlier this year, agreed on a ceasefire with Russia a month ago. The fighting has displaced nearly 1 million people in Idlib.
A crackdown by Assad on pro-democracy protesters in 2011 led to Syria's war.