BEIRUT — Airstrikes blamed on Russia hit at least two hospitals and a school in northern Syria on Monday, killing and wounding dozens of civilians and further dimming hopes for a temporary truce, as government troops backed by Russian warplanes pressed a major offensive north of Aleppo.

The raids came days after Russia and other world powers agreed to bring about a pause in fighting that would allow for the delivery of humanitarian aid and the revival of peace talks.

The projected truce agreed on Friday in Munich was to begin in a week, but there was no sign that would happen.

On Monday, Syrian state TV reported that pro-government forces have entered the northern town of Tel Rifaat, where they were fighting “fierce battles” against insurgents.

In Idlib province, an airstrike destroyed a makeshift clinic supported by Doctors Without Borders. The international charity, also known by its French acronym MSF, said the hospital in the town of Maaret al-Numan was hit four times in attacks that were minutes apart. It said seven people were killed and eight others were “missing, presumed dead.”

The Britain-based Syrian Observatory for Human Rights said Russian warplanes targeted the hospital, destroying it and killing nine people. The opposition group, which tracks both sides of the conflict through sources on the ground, said dozens were wounded in the attack.

The Observatory said another hospital in Maaret al-Numan was also hit Monday, most likely by a Syrian government airstrike.

In the neighboring Aleppo province, a missile struck a children’s hospital in the town of Azaz, killing five people, including three children and a pregnant woman, according to the Observatory. A third air raid hit a school in a nearby village, killing seven and wounding others.

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