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The Philippines is characterized by sustained economic growth and political stability, yet ****ual and reproductive health indicators have stalled or even worsened in recent decades. We employed an innovative, mixed-methods approach-Systematic Anomalous Case Analysis-to gain insights into these worsening trends by examining ****ual and reproductive decision-making among a cohort of young adults in Metro Cebu, Philippines. We first analyzed longitudinal data (1998-2009) to predict reproductive outcomes (i.e., age of first se