All her life, Roya has known that her life was inextricably linked with her mother's death. Within hours of her birth in a small village in rural Afghanistan, Roya's mother had bled to death.
She was one of the thousand women who die each day in childbirth. In addition, every year more than 7 million babies are stillborn or die shortly after birth – the majority from preventable conditions.
More than half of these deaths occur in sub-Saharan Africa, largely due to the shortage of midwives and the lack of emergency obstetric care. Sub Saharan Africa, which has 33% of the global burden of illness and deaths of mothers and children, has only 2.8% of the world's health workers.
Genuine progress in some countries shows that a rapid scale-up of the health workforce is possible. The 10,000 paid community health workers in Malawi have been called the country's "most powerful weapon" in improving child health. Travelling by bicycle, they use medical checklists to help them diagnose and treat childhood killers, such as pneumonia, malaria and diarrhoea.
Dr Lale Say from the World Health Organisation (WHO) believes that increasing the coverage of community-level health interventions could prevent almost half of childhood deaths.
"Prevention and treatment services need to be brought closer to children who are not adequately reached by the health system and other services," she says. "Many newborn deaths could be averted with a combination of outreach services and improved family and community care."
The WHO says that, in order to provide universal access to reproductive, maternal and newborn health services in the 51 countries with the lowest incomes and highest burden of disease, more than 4.2 million health workers are required. In addition, poor countries need help to strengthen their health systems through long-term, sustained investment.
"Fragile states", such as Afghanistan, need particular attention. The number of women who die in childbirth in conflict countries is almost double that of women in non conflict countries. Fifty per cent of under-fives who die, live in fragile states. Yet very little of the funding received by fragile states is long-term or predictable.
Roya says she grew up with an overwhelming longing to do something to address the maternal mortality crisis in her country. In December 2010, her ambition was realised when she graduated as a midwife in Taloqan, a remote province in north-east Afghanistan, supported by the medical relief agency, Merlin.
"I have always wanted to prevent women from going through what my mother faced," she says. "Midwifery is so important to reducing the mortality crisis. If mothers are healthy, a country is healthy and strong."