Malaysia is entering a new phase of demographic change, shaped by declining birth rates, longer lifespans, and rising caregiving responsibilities within households. These shifts place many working adults in a position where they support both elderly parents and young children simultaneously. Commonly known as the sandwich generation, this group is increasingly influencing national conversations on fertility, family planning, and long-term care.

In response, the government is expanding fertility support, strengthening reproductive health education, and enhancing services for older Malaysians to help families adapt to these emerging pressures.

Why Fertility Has Become A National Concern

At the 2025 National Population Conference, Women, Family and Community Development Minister Datuk Seri Nancy Shukri highlighted the growing trend of young Malaysians delaying marriage or choosing to have smaller families. She explained that decisions around parenthood are shaped by a combination of financial realities, career aspirations, and changing lifestyle expectations. While personal choice remains central, the government aims to improve access to information and support so couples can make well-informed decisions for the long term.

According to the Department of Statistics Malaysia (DOSM), the country’s total fertility rate dropped to 1.6 children per woman in 2022[PDF], significantly lower than the 4.9 recorded in 1970. More recent estimates place the rate at around 1.7 in 2023, still below the replacement rate of 2.1. At the same time, the proportion of Malaysians aged 65 and above continues to increase each year, adding further pressure to family structures, healthcare systems, and the workforce.

Who The Sandwich Generation Is And Why They Face Growing Pressure

The sandwich generation usually comprises adults in their thirties or forties who shoulder the dual responsibility of caring for their ageing parents while raising their own children. In Malaysia, this often occurs within multi-generational households where caregiving roles, financial obligations, and emotional duties overlap.

This group frequently faces rising living expenses, healthcare needs for parents, childcare or education costs for children, and housing commitments. Balancing these responsibilities can affect mental health, career progress, and overall financial security. Many also struggle to build adequate emergency funds or retirement savings because most resources are directed towards immediate family needs.

Cultural expectations further contribute to the workload, as many Malaysians feel a strong responsibility to care for parents at home as they age.

Expanding Fertility Support For Couples

To address declining fertility, the government is enhancing programmes under the National Fertility Plan. A key initiative is the Fertility Treatment and Infertility Advocacy Programme, known as BuAI. According to the National Population and Family Development Board (LPPKN), BuAI aims to improve understanding of fertility health including male infertility and provides support for eligible couples undergoing treatments such as intrauterine insemination.

Other forms of support include access to in vitro fertilisation services, counselling for couples undergoing treatment, and broader reproductive health guidance. The Smart Start programme, designed for newly married couples, is also being strengthened to improve understanding of family planning and reproductive health from the earliest stage of marriage.

Improving Reproductive Health Awareness Among Young Malaysians

Reproductive health education is also being expanded to reach younger Malaysians. The KafeTEEN programme, run by LPPKN, provides adolescents and students with information on sexual responsibility, the prevention of teenage pregnancies, and factors that affect fertility later in life. The goal is to build early awareness and equip young people with accurate knowledge about reproductive health so they can make responsible decisions as adults.

Considering Family Size: Is Having More Children Than You Can Afford Risky?

Deciding on family size is deeply personal, but it is directly influenced by long-term financial and emotional capacity. Raising a child involves recurring expenses that increase over time, particularly when accounting for education, healthcare, food, and housing costs. Urban households often face additional pressures such as childcare fees and higher living costs.

For families already caring for elderly parents, taking on more dependants than they can comfortably support may create sustained financial strain. This can reduce savings, limit emergency readiness, and affect a household’s ability to plan for retirement.

This does not mean families should avoid having more children. Instead, it emphasises the importance of realistic financial planning based on income stability, expected expenses, and caregiving responsibilities.

The Realities Of Being In The Sandwich Generation

Being part of the sandwich generation offers both advantages and challenges. On one hand, multi-generational living can strengthen family relationships, provide emotional support, and allow shared caregiving roles. Children often benefit from close interactions with grandparents, and families may feel a stronger sense of connection.

However, the demands of juggling elder care and childcare can be overwhelming. Many individuals face limited personal time, rising medical costs for parents, and significant monthly expenses. As financial commitments expand, retirement savings can be deprioritised, increasing the risk of financial insecurity later in life.

These challenges affect not only individual families but also the broader economy, influencing savings patterns, labour participation, and long-term national resilience.

How The Sandwich Generation Shapes Malaysia’s Social And Economic Outlook

The pressures faced by the sandwich generation have far-reaching implications. When a significant share of household income goes to caregiving, families may have less capacity to save, invest, or contribute to retirement accounts. This can weaken long-term financial stability and reduce economic resilience.

Malaysia’s ageing population requires greater investment in healthcare, long-term care, and community-based support systems. Meanwhile, a low fertility rate means fewer workers entering the labour force, placing greater pressure on current working adults to support older dependants through both family responsibilities and public systems.

According to DOSM, the proportion of older Malaysians is expected to continue rising, underscoring the need for coordinated policies involving healthcare, elder care, childcare, and retirement savings.

Building A Support System For Fertility And Ageing

To respond to these demographic challenges, the government is strengthening the care economy. This includes expanding Elderly Activity Centres, known as Pawe, and implementing the Elderly Action Plan to improve access to support services for older citizens. According to the Ministry of Women, Family and Community Development, more than 160 research projects on ageing have been completed to better understand future needs and service gaps.

Together with fertility initiatives, these efforts aim to create a more sustainable ecosystem that supports families through different stages of life.

Preparing Malaysian Families For The Road Ahead

Malaysia’s demographic shift is already underway, and the pressures on the sandwich generation reflect the broader realities of a society experiencing lower fertility and rapid ageing. Through enhanced fertility assistance, stronger reproductive health education, and improved support for older adults, the government is laying the groundwork for a more balanced and informed population strategy.

For families, careful planning around finances, caregiving roles, and family size will remain essential as the country navigates this long-term demographic transition.

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