There are limited recreational facilities. Children, particularly those in single-parent families where the parent often has to work long and irregular hours outside the home, suffer from cultural deprivation and face a conflict of value systems, which further contributes to psychosocial difficulties. Street children, working children, and young prostitutes are at special risk. A significant proportion of urban households are headed by women who, in many cases, do not have any close relatives living nearby, and the nature of the areas in which they live does not foster the development of other links of alternative support. In an urban environment, young mothers may be isolated, often living in difficult economic and social conditions.
Depressive syndromes occur frequently in such circumstances.
They may have a heavy impact not only on the mother's health, but also on the psychosocial development of the child. Despite the slowness of progress, or even horrendous defeats as history tragically repeats itself, the world community has the opportunity and instruments to foster and enrich the health and well-being of children, families, communities, and cities. Countries and the international development community have learnt a great deal about the principles, methodologies, and essential ingredients of people-centred development strategies through a focus on women, children, families, and communities. Health development concepts have evolved from a common foundation of primary health care, district-based health systems, and participatory methods in health development. While much of the development focus has been on rural areas, the concentration of population in the cities provides programmes with an economy of scale.