The evolution of NICHE: assessing the challenges and opportunities for a community health organisation in Cork city

Abstract

This study was proposed by NICHE, a community health organisation based on the North side of Cork City. NICHE wanted to capture and reflect on the role that it has played in that community for the last 20 years. This research provides an analysis of how the NICHE model has evolved over these years and the role that the community health worker has played for the people in this community. The study is contextualised within wider changes that have affected communities and community development in Ireland. The story of NICHE is set against the impact of a neoliberal policy agendas on community organisations. As a result, this research also explores the effects of neoliberalism on NICHE. This is a qualitative study combining a review of the literature with 10 semi-structured interviews documenting the thoughts and experiences of people who have worked at NICHE. Their voices and stories highlight a number of issues: first, interviewees reflected on the impact that wider policy changes have had on NICHE as a community health organisation over the years. Findings indicate that the shift from participatory democracy to a neoliberal policy agenda has had a negative impact on community development in Ireland. The top-down approach to community development, a feature of neoliberalism appears to be ineffective in reflecting the needs of a community. Community organisations would benefit from the reintroduction of structures which once supported communities in influencing policy. Secondly, in relation to the role of the community worker, this research reveals the importance of community health workers being local. However, in contrast with findings from the literature review, this study also points at some difficulties encountered by workers who live in the communities they serve which may be worthy of further investigation. Based on the findings, this study points at the need for NICHE to return to community consultation in order to assess the needs of a changing community and to determine what role NICHE may play in addressing these needs.