Table 4. Barriers for health professionals to approach family members to request consent to MITS.

Themes and categories	Illustrative quotes
Underlying tension between family members and health facility staff     • Illicit charges impeding potential mutual understanding between relatives and health care workers     • Perceived negligence	“There was no MITS, the family was not even approached by MITS consent taker. There was reticence to do so…due to money charges by the health care workers appointed to the maternity ward [the midwife]. In this case the child’s grandfather was furious because even though she [the midwife] had received money to take good care of the mother and the baby [informal gratitude], the child ended up dying. I saw no climate for an informed consent to be requested.”–observer’s field notes#
	“The parents were revolted because their severely sick child could not be referred to Maputo [Maputo Central Hospital] because the ambulance did not have enough oxygen for the child. The health facility staff were trying to say to the parents that the child would be better cared for at MDH because the prognostic was not good at all…they explained that the oxygen that was at the ward was the same that the child would be receiving in Maputo and not much else…the parents did not care, they think that the child died because of negligence.”–observation field notes#
Timing     • Health professionals’ preparedness to engage with families slower than family’s readiness to take the body back home	The family left the hospital while the consent team was getting ready to approach them–observation field notes

# Field notes taken during sessions of interactions between project’s staff and relatives of deceased children at the MDH.