Four NATO service members, including a 37-year-old Italian lieutenant, were killed across Afghanistan on Monday by roadside bombs and an insurgent attack, the coalition said.
In Rome, Italy's Premier Silvio Berlusconi said four other Italian soldiers were wounded, including three seriously, in a bomb blast about 16 miles (25 kilometers) north of Shindand district of Herat province in western Afghanistan.
Berlusconi said the attack made him wonder if Italy's sacrifice in Afghanistan was worth it, given how "medieval" the nation is. Still, he said the Italian mission in Afghanistan must continue.
NATO said two other troops were killed by bombs in the east and south and a fourth died following an insurgent attack in the east. Their nationalities were not released.
Fighting accelerated between Taliban insurgents and coalition and Afghan forces last year after 30,000 U.S. reinforcements finished arriving in Afghanistan in the summer.
The NATO forces are pushing hard to rout insurgents from their strongholds in the south and east and improve security so the Afghan government and international community can bolster governance and development work.
The latest deaths bring to 34 the number of NATO service members killed this month, after 31 were killed in January.
Last year was the deadliest of the 9-year-old Afghan war for the international forces, with 701 killed.