This RCT evaluates a culturally-adapted WhatsApp-based platform for NCD self-management among 1,200 urban Pakistani adults with diabetes and hypertension. The intervention includes automated medication reminders in Urdu, peer support groups, and direct messaging with healthcare providers. After 12 months, intervention participants showed 45% better medication adherence, 28% improvement in blood pressure control, and 31% reduction in emergency department visits compared to standard care.