NAIROBI- Fifteen months of war have left nearly 40% of the people in Ethiopia's Tigray region without enough food as aid groups struggle to reach cut-off areas, the World Food Programme (WFP) said on Friday.

Although the ability of aid workers to enter Tigray improved during the summer months and "kept starvation at bay" for people there, no aid convoy has reached Tigray since mid-December, the United Nations agency said in an assessment.

Many people were using extreme coping strategies like cutting the number of meals they eat daily, it said.

"A new food security assessment, released today by the United Nations World Food Programme, shows that almost 40 percent of Tigrayans are suffering an extreme lack of food, after 15 months of conflict," it said.

Tigray region has a population of about 5.5 million people.

The assessment said that across Tigray and the neighbouring regions of Afar and Amhara, also affected by the war, an estimated 9 million people need food aid.

The war broke out in November 2020 and pits the Ethiopian government and its allies against forces loyal to the Tigray People's Liberation Front (TPLF), the political party that controls Tigray.

The conflict has killed thousands and displaced millions across three regions in Ethiopia and into neighbouring Sudan.

Government spokesman Legesse Tulu did not immediately respond to a request for comment on the WFP assessment. On Monday he accused the TPLF of using "hunger as a political tool".

The report comes with international concerns over humanitarian access to Tigray region mounting again.

The Ethiopian government said last week that 43 trucks would deliver food and other aid to Tigray, but no trucks have arrived as fighting rages along the border between the Afar and Tigray regions. On Friday, the government said a convoy carrying food and medicine was forced to turn back due to fighting it blamed on the TPLF.

A doctor at the Ayder Referral Hospital in the Tigray regional capital Mekelle told Reuters that hospital staff have not been paid in eight months.

Some doctors and nurses have had their own children admitted to the hospital for malnutrition and some staff have resorted to begging for food, the doctor told Reuters on Thursday.

The U.N. Office for the Coordination of Humanitarian Affairs (OCHA) said on Friday that all international aid groups operating in Tigray had run out of fuel and were delivering what aid they could on foot. The government spokesperson did not immediately respond to a request for comment on that report.

OCHA spokesperson Jens Laerke told reporters in Geneva that aid groups operating in Tigray had told the agency that if there is no change in conditions, "they will be unable to provide anything by the end of February".

(Reporting by Giulia Paravicini Additional reporting by Emma Farge in Geneva Editing by Maggie Fick, Angus MacSwan and Mark Heinrich) ((Giulia.Paravicini@thomsonreuters.com; +254 20 499 1232; Reuters Messaging: giulia.paravicini.thomsonreuters.com@reuters.net))