The Philippines is characterized by sustained economic growth and political stability, yet sexual 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 sexual 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 sex, number of living children) among participants in the Cebu Longitudinal Health and Nutrition Survey to identify cases (predicted and anomalous) with whom we subsequently conducted qualitative, in‐depth interviews in 2013‐14 (n = 48). Analysis of the qualitative data revealed unique social and contextual factors that shaped patterns of sexual and contraceptive decision‐making across three, distinct reproductive life stages: (1) at first sex, (2) after the birth of first child, and (3) after the birth of several children. However, gendered roles and expectations exerted strong influences on sexual and reproductive outcomes across these life stages. Finally, we identified two constructs from our qualitative analysis—sexual fluidity and sexual agency—that deserve further examination and integration into theoretical and empirical models of sexual and reproductive decision‐making.

中文翻译：

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使用系统异常案例分析检查菲律宾的性和生殖健康结果。

菲律宾的特点是经济持续增长和政治稳定，但近几十年来，性健康和生殖健康指标停滞不前甚至恶化。我们采用了一种创新的混合方法方法——系统异常案例分析——通过检查菲律宾宿务大都会一群年轻人的性和生殖决策来深入了解这些恶化的趋势。我们首先分析了纵向数据（1998-2009 年），以预测宿务纵向健康和营养调查参与者的生殖结果（即第一个性别的年龄、在世儿童的数量），以确定我们随后进行的病例（预测的和异常的） 2013-14 年的定性深度访谈（n = 48）。对定性数据的分析揭示了独特的社会和背景因素，这些因素塑造了三个不同生殖生命阶段的性和避孕决策模式：(1) 第一次性行为，(2) 第一个孩子出生后，以及 (3)在生了几个孩子之后。然而，性别角色和期望对这些生命阶段的性和生殖结果产生了强烈影响。最后，我们从定性分析中确定了两个结构——性流动性和性能动性——值得进一步检查并整合到性和生殖决策的理论和经验模型中。性别角色和期望对这些生命阶段的性和生殖结果产生重大影响。最后，我们从定性分析中确定了两个结构——性流动性和性能动性——值得进一步检查并整合到性和生殖决策的理论和经验模型中。性别角色和期望对这些生命阶段的性和生殖结果产生重大影响。最后，我们从定性分析中确定了两个结构——性流动性和性能动性——值得进一步检查并整合到性和生殖决策的理论和经验模型中。