A/HRC/43/38 IV. Challenges and progress in ending and preventing grave violations 16. Protracted and high-intensity conflicts, cyclical spikes in violence, operations to counter violent extremism and cross-border operations by parties to conflict have continued to disproportionately affect children. Notwithstanding high levels of grave violations and challenges to protect children, important progress has been achieved in ending and preventing violations, including by improving accountability and securing the release of children from parties to conflict. A. Challenges in ending and preventing grave violations against children Recruitment and use of children 17. While the verified number of cases of children recruited and used by parties to conflict has slightly decreased in the last years, this reduction does not necessarily reflect actual progress on the ground but might be the result of difficulties to access and verify information. Volatile security situations, concerns for the protection of victims and witnesses, and financial and human resources constraints have continued to hamper verification efforts. 18. At the time of writing, the highest verified recruitment figures for 2019 were in Somalia and in the Democratic Republic of the Congo, followed by Yemen. As in previous years, children associated with parties to conflict continued to be exposed to a multitude of other violations, including killing, maiming and sexual violence. In the Central African Republic, eight boys aged between 16 and 17 years associated with the Front populaire pour la renaissance de la Centrafrique were killed (four) or maimed (four) during confrontations between the Front and the Mouvement patriotique pour la Centrafrique. 19. Even when released or separated from parties to conflict, only a fraction of children benefited from sustainable reintegration programmes. Under article 39 of the Convention on the Rights of the Child and under article 6 of its Optional Protocol on the involvement of children in armed conflict, States parties committed themselves to providing those children with all appropriate measures to promote physical and psychological recovery and their social reintegration. Additionally, endorsing States reiterated in the Paris Principles their commitment to adopt an inclusive approach to reintegration, to provide support, including financial support, to enable the full reintegration of former child soldiers into civilian life. Despite those engagements and the recognition that sustainable reintegration programmes are essential for children and their communities, not all released or separated children benefited from such programmes in 2019. Deprivation of liberty of children for their alleged association with armed groups 20. In light of the gravity and scale of the concern relating to children deprived of liberty for their alleged association with armed groups in conflict situations, the Special Representative continues to bring this matter to the attention of the Human Rights Council. In States such as Afghanistan, the Democratic Republic of the Congo, Iraq, Mali, Nigeria, Somalia and the Syrian Arab Republic, children continued to be detained purely for association with parties to conflict. 21. Thousands of children actually or allegedly associated with Islamic State in Iraq and the Levant and affiliated groups are deprived of their liberty. These children are highly vulnerable, they are survivors of heavy fighting and they have witnessed unimaginable atrocities. The latest report of the Independent International Commission of Inquiry on the Syrian Arab Republic (A/HRC/42/51), of August 2019, stated that detained children had died from malnutrition and untreated infected wounds, risk being stateless and lack access to education and health services, including essential psychological support. 22. There can be no security without respect for human rights, and military operations whose effects worsen the suffering of the civilian population can generate new, or aggravate real or perceived, grievances in affected populations with the potential to fuel 5