Meaning
Right this instant, immediately — the reduplication of 'now' intensifying it to mean without any delay at all. Where plain 'now' might allow a little slack, 'now now' insists on this very moment: 'come now now' means come at once. The doubling to sharpen or intensify a word is a common feature of Patois, and 'now now' is one of its most everyday examples, stressing urgency.
Examples
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Come yah now now!
Come here right this instant!
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Mi want it now now, not later.
I want it right now, not later.
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Him leave now now.
He left just this moment.
Origin
Reduplication of 'now' for intensity — a common Patois pattern. See One-one, Lickle more.
How it’s used
Right this instant; reduplication of 'now' for emphasis. See One-one, Lickle more.