In this article, the author comments on the article by Dutta and Basnyat (see EJ802883) that provides an insightful and comprehensive critique of a United States Agency for International Development (USAID) entertainment-education program, The Radio Communication Program (RCP) in Nepal, which has been reported to be highly participatory. Despite the contention that this family planning project was built from the "ground up" with the full participation of rural Nepalese, Dutta and Basnyat, using a conceptually based critical approach, make a convincing case that the entertainment-education project was in reality a one-way hierarchical project primarily generated by national elites and foreign donors. This analysis is derived from the culture-centered approach to participation, which assumes that community members and health educators are equal contributors to a project, including joint participation in problem definition, goal specification, intervention development, and evaluation. This author contends that what is important about the role of cultural discourse in health education is that it better informs the experts so that they can more effectively develop programs that change behavior in the community. There is no assumption that the community informants and the health educators are "equals" or that the community participants must define the problem and the educational program goals. He cites the experience of the highly successful Nepal measles-eradication program (which reportedly reduced Nepal's measles-related deaths by 90% in 1 year) as one that teaches that local participation and cultural discourse are essential for the success of health education and treatment programs. The process is interactive, both top down and bottom up, but not centered and defined by local culture.