The UN General Assembly has overwhelmingly approved a resolution blaming Russia for the humanitarian crisis in Ukraine and urging an immediate ceasefire and protection for millions of civilians and the homes, schools and hospitals critical to their survival.

The vote on the resolution was 140-5 with only Belarus, Syria, North Korea and Eritrea joining Russia in opposing the measure. There were 38 abstentions, including China.

The resolution deplores the “dire humanitarian consequences” of Russia’s aggression which it says is “on a scale that the international community has not seen in Europe in decades”.

It deplores Russia’s shelling, air strikes and “besiegement” of densely populated cities, including the southern city of Mariupol, and demands unhindered access for humanitarian aid.

The vote was almost exactly the same as on the March 2 resolution the assembly adopted demanding an immediate Russian ceasefire and withdrawal of troops.

It demands protection for all civilians and infrastructure indispensable to their survival. That vote was 141-5 with 35 abstentions.

Russia has denounced the resolution as “anti-Russian” and accuses its supporters of not really being concerned about the humanitarian situation on the ground, saying they want to politicise aid.

The vote follows the Security Council’s overwhelming defeat on Wednesday of a Russian resolution that would have acknowledged Ukraine’s growing humanitarian needs – but without mentioning Russia’s invasion that has left millions of Ukrainians in desperate need of food, water and shelter.

The council acted a few hours after the General Assembly started considering a separate resolution titled “Humanitarian consequences of the aggression against Ukraine”, which was drafted by Ukraine and two dozen other countries from all parts of the world.

There were over 70 scheduled speakers and only 62 were able to deliver their remarks, so the final speeches and vote were postponed until Thursday.