Despite a ceasefire and significant reduction in hostilities in eastern Ukraine, more than 9,000 people have died in 21 months of fighting in the region, the United Nations said in a report released Wednesday, noting that serious human rights concerns persist, including killings, torture and impunity.

The report from the U.N. Office of the High Commissioner for Human Rights, covering Aug. 16 to Nov. 15, said that 9,098 combatants and civilians have died, and nearly 21,000 have been injured since the conflict between Kiev and pro-Russian separatists began last April, reported The New York Times.

A "ceasefire within a ceasefire" agreed to in late August has resulted in the number of civilians casualties dropping by 230 percent from the previous three-month reporting period of mid-May to mid-August, with 47 civilians killed and 131 injured. Most of the casualties in the latest reporting period resulted from land mines and improvised explosive devices, "underscoring the urgent need for extensive mind clearance and mine awareness actions on both sides of the contact line," the report said, according to the Associated Press.

Gianni Magazzeni, a senior U.N. official involved in the report, noted that the real death toll is likely significantly higher, as "there remain a large number of unidentified bodies in morgues, in multiple places, especially in the areas controlled by armed groups."

The report warns that extrajudicial killings and torture continues to occur in regions controlled by separatists.

"An inflow of ammunition, weaponry and fighters from the Russian Federation into the territories controlled by the armed groups" along with "increasing skirmishes along the line of contact" are keeping the "situation highly flammable" in an area where 800,000 civilians live, the U.N. said.

The U.N. estimates that 2.9 million people living in the conflict area face difficulties in gaining access to quality medical care, shelter, social services and benefits, as well as compensatory mechanisms for damaged, seized or looted property, according to Reuters.

Further, the U.N. documented cases of "enforced disappearance, arbitrary and incommunicado detention as well as torture and ill treatment of people suspected of trespassing against territorial integrity or terrorism or believed to be supporters of the self-proclaimed 'Donetsk people's republic' and 'Luhansk people's republic.'"