UN Secretary-General Antonio Guterres on Thursday deplored the lack of civilian protection in armed conflict and the erosion of respect for international humanitarian law. "While the normative framework (for civilian protection) has been strengthened, compliance has deteriorated," he told a Security Council open debate on the protection of civilians in armed conflict. Grave human suffering is still being caused by armed conflict and lack of compliance with international humanitarian law, he said, noting that civilians continued to make up the vast majority of casualties in the conflict. In 2018 alone, the United Nations recorded more than 22,800 civilian casualties in just six countries: Afghanistan, Iraq, Mali, Somalia,  South Sudan and Yemen, he said. Most recently in Idlib in northwest Syria, there was a new wave of shelling and airstrikes against hospitals, schools, markets, and camps for the displaced, killing, wounding and creating panic among the civilian population, said the UN chief. In all conflicts, when explosive weapons were used in populated areas, 90% of those killed and injured were civilians, he said. Conflicts also displace millions of people -- both internally and across national borders, he said. Widespread access constraints jeopardize humanitarian and medical assistance to civilians in need. Violence against humanitarian and medical workers and facilities persist, he said. The World Health Organization recorded 705 attacks against health care workers and facilities in just eight conflicts, resulting in 451  deaths and 860 injuries. Up to 369 aid workers were kidnapped, wounded or killed. Starvation of civilians is used as a method of warfare, as well as rape and sexual violence, said Guterres.