JERUSALEM (AP) — The proportion of Palestinian women and children being killed in the Israel-Hamas war appears to have declined sharply, an Associated Press analysis of Gaza Health Ministry data has found, a trend that both coincides with Israel’s changing battlefield tactics and contradicts the ministry’s own public statements.
The trend is significant because the death rate for women and children is the best available proxy for civilian casualties in one of the 21st century’s most destructive conflicts. In October, when the war began, it was above 60%. For the month of April, it was below 40%. Yet the shift went unnoticed for months by the U.N. and much of the media, and the Hamas-linked Health Ministry has made no effort to set the record straight.
Israel faces heavy international criticism over unprecedented levels of civilian casualties in Gaza and questions about whether it has done enough to prevent them in an 8-month-old war that shows no sign of ending. Two recent airstrikes in Gaza killed dozens of civilians.
The AP analysis highlights facts that have been overlooked and could help inform the public debate, said Gabriel Epstein, a research assistant at the Washington Institute for Near East policy who has also studied the Health Ministry data.
The declining impact on women and children — as well as a drop in the overall death rate — are “definitely due to a change in the way the IDF is acting right now,” Epstein said, using an acronym for the Israeli army. “That’s an easy conclusion, but I don’t think it’s been made enough.”
Omar Shakir, the Israel and Palestine director for Human Rights Watch, said his group has always found the Health Ministry’s numbers to be “generally reliable” because it has direct access to hospitals and morgues.
Whatever the reason for fewer women and child being killed, Shakir said, in the grand scheme, the trend pales when compared with the war’s overall devastation. “The death toll may be an undercount,” he added, because many bodies are still under rubble and the war has made it difficult for the Health Ministry to comprehensively gather data.
AS THE WAR EVOLVES, A SHIFT OCCURS
When Israel first responded to Hamas’ Oct. 7 attack, which killed some 1,200 people, it launched an intense aerial bombardment on the densely populated Gaza Strip. Israel said its goal was to destroy Hamas positions, and the barrage cleared the way for tens of thousands of ground troops, backed by tanks and artillery.
The Gaza death toll rose quickly and by the end of October women and people 17 and younger accounted for 64% of the 6,745 killed who were fully identified by the Health Ministry.
After marching across most of Gaza and saying it had achieved many key objectives, Israel then began withdrawing most of its ground forces. It reduced the frequency of aerial bombings and has focused in recent months on smaller drone strikes and limited ground operations.
As the intensity of fighting has scaled back, the death toll has continued to rise, but at a slower rate – and with seemingly fewer civilians caught in the crossfire. In April, women and children made up 38% of the newly and fully identified deaths, the Health Ministry’s most recent data shows.
“Historically, airstrikes (kill) a higher ratio of women and children compared to ground operations,” said Larry Lewis, an expert on the civilian impacts of war at CNA, a nonprofit research group in Washington. The findings of the AP analysis “make sense,” he said.
Another sign that Israel softened its bombing campaign: Beginning in January, there was a sharp slowdown in “new damage” to buildings in Gaza, according to Corey Scher, a satellite mapping expert at City University of New York who has monitored buildings damaged or destroyed since the war began.
DAILY DEATH TOLLS AT ODDS WITH UNDERLYING DATA
The Health Ministry announces a new death toll for the war nearly every day. It also has periodically released the underlying data behind this figure, including detailed lists of the dead.
The AP’s analysis looked at these lists, which were shared on social media in late October, early January, late March, and the end of April. Each list includes the names of people whose deaths were attributable to the war, along with other identifying details.
The daily death tolls, however, are provided without supporting data. In February, ministry officials said 75% of the dead were women and children – a level that was never confirmed in the detailed reports. And as recently as March, the ministry’s daily reports claimed that 72% of the dead were women and children, even as underlying data clearly showed the percentage was well below that.
Israeli leaders have pointed to such inconsistencies as evidence that the ministry, which is led by medical professionals but reports to Gaza’s Hamas government, is inflating the figures for political gain.
Experts say the reality is more complicated, given the scale of devastation that has overwhelmed and badly damaged Gaza’s hospital system.
Lewis said while the “beleaguered” Health Ministry has come under heavy scrutiny, Israel has yet to provide credible alternative data. He called on Israel to “put out your numbers.”
HIGH CIVILIAN DEATH TOLL IS A LIABILITY FOR ISRAEL
The true toll in Gaza could have serious repercussions. Two international courts in the Hague are examining accusations that Israel has committed war crimes and genocide against Palestinians – allegations it adamantly denies.
Israel has opened a potentially devastating new phase of the war in the southern Gaza city of Rafah, where an estimated 100,000 civilians remain even after mass evacuations. How Israel mitigates civilian deaths there will be closely watched.
Israeli airstrikes in Rafah last month set off a fire that killed dozens of people, and on Thursday an airstrike on a school-turned-shelter in central Gaza killed at least 33 people, including 12 women and children, local health officials said.
Israel says it has tried to avoid civilian casualties throughout the war, including by issuing mass evacuation orders ahead of intense military operations that have displaced some 80% of Gaza’s population. It also accuses Hamas of intentionally putting civilians in harm’s way as human shields.
The fate of women and children is an important indicator of civilian casualties because the Health Ministry does not break out combatant deaths. But it’s not a perfect indicator: Many civilian men have died, and some older teenagers may be involved in the fighting.
PARSING GAZA HEALTH MINISTRY DATA
The ministry said publicly on April 30 that 34,622 had died in the war. The AP analysis was based on the 22,961 individuals fully identified at the time by the Health Ministry with names, genders, ages, and Israeli-issued identification numbers.
The ministry says 9,940 of the dead – 29% of its April 30 total – were not listed in the data because they remain “unidentified.” These include bodies not claimed by families, decomposed beyond recognition or whose records were lost in Israeli raids on hospitals.
An additional 1,699 records in the ministry’s April data were incomplete and 22 were duplicates; they were excluded from AP’s analysis.
Among those fully identified, the records show a steady decline in the overall proportion of women and children who have been killed: from 64% in late October, to 62% as of early January, to 57% by the end of March, to 54% by the end of April.
Yet throughout the war, the ministry has claimed that roughly two-thirds of the dead were women and children. This figure has been repeated by international organizations and many in the foreign media, including the AP.
The Health Ministry says it has gone to great lengths to accurately compile information but that its ability to count and identify the dead has been greatly hampered by the war. The fighting has crippled the Gaza health system, knocking out two-thirds of the territory’s 36 hospitals, closing morgues and hampering the work of facilities still functioning.
Dr. Moatasem Salah, director of the ministry’s emergency center, rejected Israeli assertions that his ministry has intentionally inflated or manipulated the death toll.
“This shows disrespect to the humanity for any person who exists here,” he said. “We are not numbers … These are all human souls.”
He insisted that 70% of those killed have been women and children and said the overall death toll is much higher than what has been reported because thousands of people remain missing, are believed to be buried in rubble, or their deaths were not reported by their families.
AS DEATH TOLL RISES, THE DETAILS ARE DEBATED
To be sure, this war’s death toll is the highest of any previous Israel-Palestinian conflict. But Israeli leaders say the international media and United Nations have cited Palestinian figures without a critical eye.
Israel last month angrily criticized the U.N.’s use of data from Hamas’ media office – a propaganda arm of the militant group – that reported a larger number of women and children killed. The U.N. later lowered its number in line with Health Ministry figures.
Israel’s foreign minister, Israel Katz, lashed out on the social platform X: “Anyone who relies on fake data from a terrorist organization in order to promote blood libels against Israel is antisemitic and supports terrorism.”
AP’s examination of the reports found flaws in the Palestinian record keeping. As Gaza’s hospital system collapsed in December and January, the ministry began relying on hard-to-verify “media reports” to register new deaths. Its March report included 531 individuals who were counted twice, and many deaths were self-reported by families, instead of health officials.
Epstein, the Washington Institute researcher, said using different data-collection methodologies and then combining all the numbers gives an inaccurate picture.
“That’s probably the biggest problem,” he said, adding that he was surprised there hadn’t been more scrutiny.
The number of Hamas militants killed in the fighting is also unclear. Hamas has closely guarded this information, though Khalil al-Hayya, a top Hamas official, told the AP in late April that the group had lost no more than 20% of its fighters. That would amount to roughly 6,000 fighters based on Israeli pre-war estimates.
The Israeli military has not challenged the overall death toll released by the Palestinian ministry. But it says the number of dead militants is much higher at roughly 15,000 – or over 40% of all the dead. It has provided no evidence to support the claim, and declined to comment for this story.
Shlomo Mofaz, director of Israel’s Meir Amit Intelligence and Terrorism Information Center, said such estimates are typically based on body counts, battlefield intelligence and the interrogations of captured Hamas commanders.
Mofaz, a former Israeli intelligence officer, said his researchers are skeptical of the Palestinian data.
In previous conflicts, he said his researchers found numerous “inconsistencies,” such as including natural deaths from disease or car accidents among the war casualties. He expects that to be the case this time as well. The large number of unidentified dead raises further questions, he said.
Michael Spagat, a London-based economics professor who chairs the board of Every Casualty Counts, a nonprofit that tracks armed conflicts, said he continues to trust the Health Ministry and believes it is doing its best in difficult circumstances.
“I think (the data) becomes increasingly flawed,” he said. But, he added, “the flaws don’t necessarily change the overall picture.”
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AP correspondents Julia Frankel in Jerusalem, Najib Jobain in Cairo and Lujain Jo in Beirut, Lebanon, contributed to this report.