That is when the GHF took over most aid distribution in Gaza in an attempt by Israel to bypass the UN as the main supplier of aid.

The move followed a complete three-month Israeli blockade during which no food entered the territory, putting the entire population at critical risk of famine according to a UN-backed assessment.

In almost all incidents, witnesses have said that Israeli troops opened fire, although there have also been reports of local armed gunmen shooting at people.

A spokesperson for al-Awda hospital in Nuseirat confirmed they received 23 bodies and more than 100 wounded. Images from the hospital showed bodies on the floor.

The IDF said the incident was under review.

The UN children's agency Unicef said the Israel- and US-backed food distribution system run by GHF was "making a desperate humanitarian situation worse".

Unicef spokesperson James Elder said a lack of public clarity on when the sites, some of which are in combat zones, were open was leading to mass casualty events.

"There have been instances where information (was) shared that a site is open, but then it's communicated on social media that they're closed, but that information was shared when Gaza's internet was down and people had no access to it," he told reporters in Geneva.

He said many women and children had been wounded while trying to receive food aid, including a young boy who was wounded by a tank shell and later died.

On Thursday, at least 12 Palestinians were killed by Israeli forces while waiting for aid, according to rescuers and medics. The GHF denied there were any incidents near its site. The Israeli military told Reuters that "suspects" had attempted to approach forces in the area of Netzarim, and that soldiers had fired warning shots.

On Tuesday witnesses said more than 50 people were killed when Israeli forces opened fire and shelled an area near a junction to the east of Khan Younis, where thousands of Palestinians had been gathering in the hope of getting flour from a World Food Programme (WFP) site, which also includes a community kitchen nearby. The Israeli military said "a gathering" had been identified "in proximity to IDF troops operating in the area" and the incident was under review.

Unicef also warned that Gaza was facing a man-made drought as its water systems were collapsing. Just 40% of drinking water production facilities were still functioning, Mr Elder said.

"Children will begin to die of thirst," he said, adding: "We are way below emergency standards in terms of drinking water for people in Gaza."

In a separate Israeli attack on Friday, a medic with the Palestinian Red Crescent told the BBC that 11 Palestinians were killed and others injured in an Israeli airstrike targeting a home in the al-Ma'sar area west of Deir al-Balah in central Gaza.

Eyewitnesses said Israeli warplanes struck a two-storey house belonging to the Ayash family.

Hamas-run civil defence officials say Israel has carried out a wave of deadly air strikes on Gaza in recent days, following a brief lull in air operations that coincided with the escalation between Israel and Iran.

They reported on Thursday that at least 77 Palestinians had been killed in such strikes, which heavily targeted the Shati area in western Gaza City.

Local sources speculated that the renewed strikes may be linked to the targeting of Hamas security elements who have recently re-emerged across parts of Gaza, attempting to reassert control amid a breakdown in law and order. These movements appear to have been timed with the temporary easing of Israeli aerial surveillance due to the simultaneous military focus on Iran.

The Israeli military launched a campaign in Gaza in response to the Hamas-led attack on southern Israel on 7 October 2023, in which about 1,200 people were killed and 251 others were taken hostage.

At least 55,706 people have been killed in Gaza since then, including more than 15,000 children, according to the territory's Hamas-run health ministry.