This qualitative study seeks to understand the caregiving needs and challenges facing sandwich Malay women from low income families in the Health District @ Queenstown who are performing multiple generation caregiving responsibilities. Their health literacy in terms of their range of skills and competencies to comprehend, access and evaluate health information and services and make informed choices towards reducing health risks and enhance not only the health and well-being of their care recipients but also their own, is the overriding aim of this study. Understanding and addressing the needs and health literacy of this targeted group will contribute to improve not only the quality of care they dispense to their care recipients especially the elderly, but also help them better manage their challenges and lifestyles to avoid dependence on their families and institutions in the long run.  Service providers, better informed of their condition and needs of this group of caregivers can help design relevant, appropriate and accessible services and interventions.