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Syrian President Bashar al-Assad said Sunday his forces must push on with their campaign to retake the besieged enclave of Eastern Ghouta from rebels, despite mounting global calls to end the bloodshed.

Government forces engaged in clashes with rebels in the eastern area of the enclave on Sunday, the Syrian Observatory for Human Rights said, after advances in recent days that saw the government seize control of 10 percent of the region.

Some of the heaviest fighting on Sunday was concentrated in the area of Beit Sawa on the eastern edge of the densely populated centre of eastern Ghouta, where civilians fled clashes between government forces and Jaysh al-Islam, one of three main rebel groups.

However, despite mounting worldwide pressure on Syria and its backer, Russia, to allow access for aid and the evacuation of the wounded and civilians, a promised daily five-hour humanitarian pause has failed to materialise as forces loyal to Assad continued to press their assault.

Hundreds of people were reported to have fled the bombardment by government forces. Rebel officials have consistently denied stopping civilians from leaving.

"Most of it is farms and there are few towns in [the captured area]", said the Observatory's director, Rami Abdulrahman.

"The majority (of people) in Eastern Ghouta want to escape the embrace of terrorism".

Terrorists are using Eastern Ghouta as a launchpad for near-daily attacks on the capital.

The bombing and shelling of civilians in Eastern ghouta and other parts of Syria may have characteristics of war crimes.

Much-needed United Nations aid - including a 45-truck convoy with enough supplies for 90,000 people in 10 locations - was unable to enter the war-torn enclave.

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The Observatory estimated that between 300 to 400 families, which is likely several thousand people, had fled areas seized by government forces since Saturday.

Macron was set to speak by telephone Sunday with President Hassan Rouhani of Iran, another key supporter of the Syrian regime.

Moscow has offered safe passage to non-combatants wishing to leave the enclave during the pause, but no Syrian civilians have left since the first break in fighting took effect on Tuesday, the Observatory says.

Rebel forces responded Sunday by launching a counteroffensive.

At least 76 pro-government fighters and 43 rebels from Jaish al-Islam have also been killed in clashes since 25 February, it says.

In a statement, the UN said the aid convoy will consist of 46 truckloads of health and nutrition supplies, along with food for 27,500 people in need and will be led by Ali Al-Za'tari, the UN Resident Humanitarian Coordinator.

Moumtzis also expressed concern about the situation in Afrin, a Kurdish region under Turkish assault since January, saying there were "disturbing reports" of civilian deaths and injuries and restrictions on civilian movement.

The Observatory said Turkish forces had advanced to within 12 km (7 miles) of Afrin.

Turkey has rejected Western calls for it to suspend the Afrin assault in line with the United Nations ceasefire, which does not apply to Islamic State, al-Qaida and groups associated with it, or other groups deemed terrorists by the Security Council.