The South Sudan civil war has caused the deaths of 382,000 people, far higher than previous estimates, a new study said.

The findings were based on statistical models that compared actual deaths with expected deaths based on census projections and previously collected mortality data.

“It is clear that the war has severely affected the health of the South Sudanese population, and that the humanitarian response to the crisis has been insufficient,” said Francesco Checchi, a professor of epidemiology and the lead author of the report.

The U.S. State Department and the American Institute of Peace funded the study that was published in the London School of Hygiene and Tropical Medicine.

Checchi said combatants in South Sudan must give aid groups free and safe access to people in need across the country.

“More fundamentally, our estimates illuminate the human cost of the war and should spur warring parties and international actors to seek lasting conflict resolution,” he added.

The war in South Sudan broke out in December 2013, two and a half years after the country won independence from Sudan.

The conflict has displaced about two million people inside South Sudan and prompted another 2.5 million to flee to neighbouring countries.

South Sudanese President Salva Kiir and chief rebel leader Riek Machar recently signed a renewed peace accord, in the latest attempt to stop the fighting and stabilise the Central African country.

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