Health promotion funding, workforce recruitment and turnover in New Zealand.

Introduction: Almost a decade on from the New Zealand Primary Health Care Strategy and amidst concerns about funding of health promotion, we undertook a nationwide survey of health promotion providers.

Aim: To identify trends in recruitment and turnover in New Zealand's health promotion workforce.

Methods: Surveys were sent to 160 organisations identified as having a health focus and employing one or more health promoter. Respondents, primarily health promotion managers, were asked to report budget, retention and hiring data for 1 July 2009 through 1 July 2010.

Results: Responses were received from 53% of organisations. Among respondents, government funding for health promotion declined by 6.3% in the year ended July 2010 and health promoter positions decreased by 7.5% (equalling 36.6 full-time equivalent positions). Among staff who left their roles, 79% also left the field of health promotion. Forty-two organisations (52%) reported employing health promoters on time-limited contracts of three years or less; this employment arrangement was particularly common in public health units (80%) and primary health organisations (57%). Among new hires, 46% (n=55) were identified as Maori.

Discussion: Low retention of health promoters may reflect the common use of limited-term employment contracts, which allow employers to alter staffing levels as funding changes. More than half the surveyed primary health organisations reported using fixed-term employment contracts. This may compromise health promotion understanding, culture and institutional memory in these organisations. New Zealand's commitment to addressing ethnic inequalities in health outcomes was evident in the high proportion of Maori who made up new hires.